Living with HIV

HIV, though chronic, is now a manageable disease with over 20 medications available to treat it. However, successful treatment requires not missing a single dose of medication (adherence); otherwise, resistance will develop and future therapies may be less successful. Plus, maintaining an undetectable viral load usually prevents disease progression. It can be said that maintaining an undetectable virus <50 copies and a CD4 count above 500 for 5 years can result in a normal life span.

The HIV virus can cause a generalized inflammatory state in the body that can have harmful consequences, such as premature aging, heart disease, lipid abnormalities and more. Taking one aspirin daily may be of benefit as an anti-inflammatory agent. Aspirin also reduces the risk of heart attack and stroke by preventing blood clots in the circulatory system.

New recommendations by the Department of Health and Human Resources (www.aidsinfo.nih.gov/guidelines) now recommend starting HIV therapy earlier. The benefits of earlier therapy outweigh the risks. Older and complicated therapies, including those with side effects, can now be safely changed to simpler ones that are easier to take, often just once a day, and maintain their effectiveness.

 
HIV prevention remains a priority worldwide. The test and treat strategy is an option currently being explored. This would involve an increase in HIV testing of the population at large and treating all positive individuals regardless of their CD4 or viral load counts.  This has some risk, including resistance; however, the potential is the reduction of the transmission of HIV.

Cosmetic Medicine: Feel Great, Look Terrific!

Age 60 is the new 40 for both men and women. Thanks to the advancement of medical science, people are living longer and staying healthier. People want to be well and look well too. Cosmetic medicine is evolving with new non-invasive procedures to make you look as young and healthy as you feel.

Technology has made it possible for primary care physicians to perform these procedures safely in the office with very little recovery or downtime. Laser treatments can tighten your skin, eradicate age spots, remove unwanted hair, resurface your skin, and reduce wrinkles. 

Botox injections can remove or reduce worry lines, frowns, and wrinkles. It can also change the shape of your eyebrows or perk up sagging eyelids. Facial fillers turn back the clock by filling in the hollow areas of your face.

Skin care products have been improved, too, and are very effective in maintaining a healthy and youthful skin. “Cosmeceuticals” are most effective when prescribed by a knowledgeable health care provider or esthetician. Consultation is required to determine the products best suited for you. Antioxidants, serums, and exfoliates need to be prescribed and used correctly as well as all cosmeceuticals. And remember: Always use a good moisturizer and sun block!

What is all this worth? A healthy, radiant glow on the outside increases the warm feelings of health and self esteem on the inside. Feeling good and looking your best have proven beneficial health consequences.

General Medicine

It is critical that patients are truthful with their physicians. Hiding information from or misleading your health care provider not only has no benefit, it could have very serious consequences. Remember, your doctor works for you and anything you say in your doctor’s office is strictly confidential.

Make the most of the time allotted with your doctor. Prepare for your office visits in advance. Write down your questions for the doctor in advance. Maintain a notebook with your symptoms and diagnoses. Keep a continuously updated list of your medications in this book. Let your doctor read your notations and ask questions, if necessary, to obtain any additional information important to your care.

Remember, multiple concerns may require more than one visit. Prioritize your list of concerns. Follow up with your doctor as requested. And always communicate with the office if you are not progressing as expected

It is beneficial to have a significant other as an active participant in your health care. This can be a family member or friend. Make sure to include open and honest communication with this individual about what you are doing, how you are feeling, and what medications you are taking. Ideally this person, as part of your health care team, should go with you to your doctor visits. They can help you remember important information or instructions from your doctor that you may have forgotten.

Most people put off making a living will and power of attorney giving instructions on how you want to be treated in case you are unable to make your own decisions about you health care. Give a copy to your physician as well as the person who is your personal representative and health care advocate. Let family members know who this person is.

Become proactive and an active participant in your health. Studies show that this empowerment has healthful effects.