Hair of the Dog
Welcome to another day in my life. Today is Friday and while it start off as another gorgeous day here in south Florida by late afternoon we were having wind gusts and thunderstorms. So unfortunately the rain will probably end up canceling City Walk that happens where I live in Wilton Manors. I hope you have had a safe and great week as I have.
Yesterday after I did my blog entry, I attended a meeting at Fusion about building local quilt panels for the National AIDS Quilt. It brought back many memories, some great and some sad, of when we first starting making quilts for friends in the 80s. All three of my partners and my god child who passed from AIDS have quilt panels. Not to mention more friends than I can count. So it was bittersweet but enjoyable to share my story and watch as others learned how to make quilt panels in memory of their loved ones.
My day today was pretty much routine with dog walks, working on emails and trying to get some exercise. It was the first time I have worked out my legs in a few month since the stroke. So even thought I took it easy I am sure I will be feeling it tomorrow. But you have to start somewhere. I am still too young to let my body fall apart and old enough for it to happen very easily.
I have been talking in my last few blogs about adherence and HIV medications. Today, I would like to talk about some things that might help you to take your treatment properly.
Simple forgetfulness is a common reason for missing doses of anti-HIV drugs. If you do forget to take your medication don't be too hard on yourself, but do try to learn from the experience about what it was that caused you to forget. If you are missing doses regularly, then discuss this with your doctor. It may be possible to make your schedule easier, or to change to a more suitable combination. Where this is not an option, talking through your concerns with your health care team may provide you with the support you need to manage your treatment better.
Some people have found that taking practice doses of sweets or multivitamins for a few weeks in the same quantities, and at the same time, as you will have to take your anti-HIV drugs regimen and taking account of any dietary or other restrictions, helps them to adhere to their actual regimen when they start it.
Keeping a diary
Confusion over which pills to take when, and what times to eat or avoid food, may be a problem when starting a new combination. To avoid this, your doctor or pharmacist can provide a written daily schedule with your prescription, which you can tick off after taking your dose. Some pharmacists offer stickers for medication containers, which have the same function.
Partitioned containers that you fill once a week or every few days with the individual daily doses are available. With some versions you can take out a single day's dose, or several if you may be away for some time. Your HIV pharmacist should be able to provide one of these boxes free. Make sure that the box you're getting is big enough and that you have checked with your pharmacist that all your drugs are suitable for storing out of their original container. Some pills deteriorate if not kept correctly. The bottle that Truvada comes in, for instance, contains a small capsule that keeps the tablets dry.
Setting an alarm on your mobile phone or watch can serve as a useful reminder to take your pills.
Keeping spare doses of pills in your bag, jacket pocket, at work or college, at a friendís or in the glove compartment of your car can mean that you have a dose available if you forget to take your pills or are unexpectedly away from home.
Overcoming food restrictions
If you need to take your HIV treatment on an empty stomach, try taking your pills just before you go to bed. Itís normally necessary to have a two hour gap between eating and taking your medication, to take your pills on an empty stomach. You should then wait at least 30 minutes before eating again.
If you have to take your HIV treatment with food, it is useful to know that it is usually not necessary to eat a full meal. A bar of chocolate or a bowl of cereal is often sufficient.
Holidays and going out
Think about how going away for a break or on holiday could impact on your adherence. This could include the effect of travel on the times you take your medication, particularly if you are traveling a long way involving a changed time zone. You should try and ensure that you take your medication at the same intervals. Make sure that you take enough medication with you, as securing more supplies might be impossible. You should also travel with your medication in your hand luggage as this is less likely to get lost and means that your medication is close at hand should you need to take any during your journey.
If you are flying or traveling across borders consider getting a letter from your doctor giving the name and doses of the medications you are taking and explaining that you need to have the medication with you at all times. This will help ensure that you are allowed to carry the medication in your hand luggage (in case the airline is imposing any restrictions on what can be carried) and it may help you with customs officials should you be stopped. This letter does not have to mention HIV.
Some countries, most notably the USA (although this may soon change), impose entry restrictions on people with HIV. There is some evidence that a small number of people traveling to the US take a break from their HIV treatment because they are worried about their medicine being found in their luggage at customs and their entry to the US denied.
Talk to your doctor before taking any break from your HIV treatment.
Breaking your routine may also have an impact on adherence as you may be away from prompts that helped you remember to take your medication. Think about what these might be and how to overcome them.
Taking your medication away from home may mean that there is an increased chance that you will have to take it with people who do not know about your health, or who you do not want to know about it. Plan in advance how you might manage this. Simple things such as having a bottle of water by your bed might give you the privacy you need to take your medication.
If you are going out for the night and think that there is a chance that you may not go home before your next medication dose or doses, then take enough medication with you to cover that period. Be aware that door staff may not be able to recognize prescription medication and some people have been asked what their anti-HIV drugs are or have had them taken away when trying to get into some clubs. Also if you are going out and are planning to drink alcohol or take drugs which might affect your memory, then try to plan in advance how you might overcome this. This could involve setting an alarm on your watch or telling a friend to remind you when it is time to take your medication.
If you are concerned about possible interactions between your HIV medication and recreational drugs then speak to your doctor or another member of your health care team. They should be able to offer advice on safely minimizing interactions. Do not skip doses.
If you are having ongoing difficulties taking your medication, or are worried, ask for help immediately. Staff at your HIV clinic are there to help, and there are other sources of support.
Check back tomorrow for another entry in helping you live with HIV and AIDS. Until we meet again; here's wishing you health, hope, happiness and just enough.
big bear hug,