Response from Dr. Frascino
Hey Brian,
The best HIV care, in my opinion, can be found in metropolitan areas that have had lots of experience treating folks with HIV and which also have a well-recognized medical center. I may be biased (and probably am), but certainly California has great care (Los Angeles and San Francisco). Other centers of excellence can be found in New York City, Chicago and Miami. There are also many excellent HIV specialist physicians throughout the U.S. For a complete list of certified HIV specialists, I'd suggest you check out the American Academy of HIV Medicine's Web site at www.aahivm.org. They have a listing of all certified HIV specialists by locale. I'll reprint some information below from the archives that discusses how to choose an HIV specialist.
Good luck Brian!
Dr. Bob
Confusion
Aug 22, 2008
Dear doctor
I am hiv positive, recent i went to test for the cd4 count and it came at 24 and the percentage at 1.8% while the viral load stood at 55 000. What is confusing me is that health wise i feel okey and and gaining weight from 79kg to 90kg in August. One think i must admit, i have been stressed to much over the past months. Could stress have contributed to these numbers. Should i go for second test to very the accurate of these numbers. I am total confused because health wise i am feel okey.
Please help
Thank you
Response from Dr. Frascino
Hello,
Are you under the care of an HIV specialist? If not, you need to contact one immediately. If you don't know how to find a certified HIV physician specialist, check the American Academy of HIV Medicine's Web site at www.aahivm.org. There you will find a list of certified HIV specialists listed by local. (Also see information below regarding choosing an HIV specialist.)
Your recent laboratory results indicate you have AIDS and that your immune system has been severely compromised by the virus. This places you at considerable risk for developing a wide variety of opportunistic infections. Stress can have some effect on immune parameters, but there is no doubt you have advanced-stage AIDS and are in desperate need of immediate intervention. The HIV specialist will repeat your studies and start you on several medications to help prevent certain opportunistic infections, such as PCP (Pneumocystis carinii pneumonia), MAC, etc. He will also recommend you begin antiretroviral therapy immediately to decrease viral replication and hopefully allow some degree of immune reconstitution (increase in your CD4 cell count).
Do not delay. Turn off the computer and make the call to an HIV specialist now! Right now. So why are you still reading this? I said call now. Yes, right now!
I'm here if you need me, OK?
Dr. Bob
Re: Need of a private doctor Aug 16, 2008
Dear Dr. Bob, Thank you for all the information you provided in finding the right doctor. I really like the article you attached. You are the Man, you rock. Thank you much
Response from Dr. Frascino
Hi,
Thanks for your thanks! Rock on and let's get through this together, OK?
I'm here if you need me.
Dr. Bob
Need a Private doctor Aug 14, 2008
I am HIV Positive living in Seattle area. I currently don't have one and i am looking urgently in a private clinic? Do you know a good one? I asked this question earlier & was told about Peter Shalit who is fully booked until end of year. Please let me know if you have a good one in mind. Thank You.
Response from Dr. Frascino
Hi,
I would suggest you consult the American Academy of HIV Medicine Web site (www.aahivm.org). There you will find a list of certified HIV specialists arranged by locale. There are a number of well-qualified HIV specialists in the Seattle area. Be sure you hook up with one that you trust and with whom you can easily communicate. Your health insurance plan may have some restrictions, so remember to check this out as well. I'll repost some information below from the archives pertaining to locating an HIV specialist.
Good luck.
Dr. Bob
Choosing an HIV Care Provider
July 18, 2007
Why Is Choosing an HIV Care Provider Important?
Treating HIV disease is very complicated. There are choices to consider at every stage of the disease. It's best if you and your health care provider work together as a team. That makes it easier to choose and stick to your treatment plan. "Care provider" means a doctor, a physician's assistant, or a nurse practitioner.
There are several issues you may want to consider in choosing an HIV care provider. You might decide to have them be your "regular doctor" for all of your health issues. You might use a different care provider for most health issues and use your HIV provider as a specialist. If your regular provider isn't an HIV specialist, be sure they regularly get expert advice on HIV issues.
Training and Experience
Many people with HIV/AIDS get their care from physicians who are specialists in infectious diseases. However, especially now that people are living longer with HIV, it's important to deal with all of your health issues. You might prefer to have a family practitioner or a specialist in internal medicine as your primary physician.
No matter what their specialty, you will get better HIV care from providers who have experience treating people at all stages of HIV disease. Be sure to ask how many patients with HIV they have treated, and how many they currently see. HIV patients do better when their physicians have more experience treating HIV disease.
Do You Have Similar Ideas About Treating HIV?
Some providers are conservative. They prefer "tried and true" methods. Others are more aggressive. They are willing to try new and experimental treatments. Some are optimistic by nature, and focus on the hopeful or positive side when they talk about test results or future prospects. Others are more realistic. Some are pessimistic.
Some providers are comfortable suggesting "complementary and alternative" therapies such as massage, acupuncture, or herbs. Others stick strictly to Western medicine.
If you want a lot of emotional support, you probably won't be comfortable with a health care provider who only talks about test results. The more comfortable you are with their approach to HIV treatments, the easier it will be for you to get the kind of health care you want. Talk to providers and their patients before you make your choice.
The Provider-Patient Relationship
Many patients do better when they take an active role in planning their own health care. These patients do a lot of reading on their own, and bring information to their providers. They work together to make health care decisions.
Other patients are more comfortable with the provider making important decisions. Decide how you want to work with your provider. See if that fits with the way the provider likes to work with patients.
Help Your Provider Help You
Make sure that your provider has all the information needed to give the best advice about your treatment. This starts with your medical records, which may have to be transferred from another office. When you start working with a new provider, they will probably do a lot of tests to collect "baseline" information. This helps you see how well you're doing as time goes by.
Be sure your provider knows how you feel about using medications, and about your illness. Some people don't mind taking a lot of pills. Other people would rather take as few as possible. Are you willing to change your diet, or the amnount of exercise you do? Your provider should also know about other treatments you are using or want to try, including non-medical ones.
Be honest about your lifestyle. Your eating, sleeping, and work patterns can make a difference for your health care. So can your sexual practices and use of recreational drugs. If your provider seems too judgmental, try to change providers. It's better to have a provider who really knows you instead of holding back information.
Let your provider know about the important people in your life: the people who will support you if you get sick, or will help you make important medical decisions.
Availability
The best care provider won't do you any good if you can't get in to see them. Ask them (or their receptionist) how long it usually takes to get an appointment. Find out how well they usually stay on schedule during the day.
The type of insurance you have could limit your choice of a provider. Maybe the provider isn't on the list for your health maintenance organization (HMO) or insurance plan. Be sure to find out how you will be able to pay for their services.
Remember, you don't need an HIV specialist to help you with most of your health care needs. If a good HIV provider is hard to find, or if it's hard to get an appointment, use a non-HIV care provider for your general health care. Just be sure that when you are dealing with HIV issues, you see an experienced HIV provider, or one who consults with an expert in HIV.
Confidentiality
Some people are very concerned about keeping their HIV status private. You might choose to get your HIV care from a provider in another town to protect your privacy. You will need to find your own balance between confidentiality and convenience.
Changing Providers
Your health care needs might change as time goes by. Also, your ideas about treatment could change. Although you will probably get better medical care from a provider who has known you for a long time, you always have the right to stop seeing one provider and change to another.
To Find a Health Care Provider ...
You can get help finding a care provider from your case manager or from your local Department of Health. You can also ask other people living with HIV. The American Academy of HIV Medicine has a web page to help you find a doctor at http://aahivm.org/web/index.php?option= com_comprofiler&task=usersList.
The Bottom Line
HIV medical care is very complicated, and changes quickly. This makes it important to find an HIV care provider who works with HIV/AIDS patients and is committed to staying up to date. Your relationship with an HIV provider will be better if you are comfortable with each other's personal style and approach to dealing with health issues in general, and HIV in particular.
|
