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Always Hurting.
Jan 31, 2003

Dear Doc, I have been dianosed as being HIV positive in Oct of 2002, I had been suffering from tiredness and alot of pain in my joints,bones and my lymphnodes are swelling and causing alot of pain. I have consulted with my HIV dr and he has precribed Lortab 7.5 every 6 hrs for the pain. I hate taking to narcotics all the time because i am afraid of "getting hooked" on them. I try to take tylenol ex strength to help with the pain and when I am hurting the worst neither seem to help.Here in the past couple of weeks I have been hurting more then usual and the Lortab 7.5 really isn't helping with the pain at all, so I don't take them I feel that I hurt so bad right now andif I do take the lortab the lasting effectiveness of the medication is'nt lasting enough. my viral load is at over 300000 and my t-cells are 487 as of oct 2002. I am at mt ropes ends here. Can you please help me and give me some recomindations on other pain medications that I might talk to my dr about on my next visit?

Hope that you can help.

Thank you, David

Response from Dr. Frascino

Hello David,

Pain control? OK, we'll talk about that in a moment. However, the more important question is why are you in pain? You need to address this issue immediately with your HIV specialist! A variety of laboratory tests may need to be done in order to help establish a firm diagnosis. You may even need the advice of an HIV-knowledgeable neurologist to help localize and characterize your pain syndrome. Neurologists are also experts in pain control management. Medications are available to knock out anything from "Excedrin Headache #9" all the way up to the sadistic dentist who wants to do a double root canal.

Also, what's going on with your HIV infection? Your CD4 cells are quite good at 487, but a viral load of 300,000 is worrisome. Hopefully your HIV doctor has ordered a resistance test, and will be considering starting or changing your HIV meds very soon.

Bottom line, David: An accurate diagnosis of the cause of your pain should be your first priority. Using narcotic pain control during the workup of this problem should not lead to addiction. Take what you need and no more. Once the underlying cause of the pain is found and treated, your need for pain killers should rapidly dissipate.

Good luck.

Dr. Bob


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