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Chronic meningitis, fatigue & zip-drive
Sep 22, 1998

I've been poz for 11+ years. I've had chronic meningitis since 1992 (HIV infection proved by CSF viral load)

My last tests dated 8/14/98 gave the following results: T4 - 1261, viral load-undetectable (blood), coccidioides-neg, free testosterone-9.2, wbcc-7.7, rbcc-4.14. Everything else was normal. I haven't had a CSF viral load in 18 months since I've been told there's nothing they can do about it anyway and I hate the spinal taps.

I'm taking: Viramune 220x2, Viracept 1250x2, Zerit 40x2, Epivir 150x2, Paxil 20x2, MS Contin 30mgx4 (headaches)

I have absolutely NO energy, nothing, zip. I'm working full time (system analyst) but I come home, maybe watch TV for an hour and sleep till getting up for work the next day.

Can you suggest anything at all? This "quality of life" is dragging me down. Prior to the MS Contin I didn't work for 2 years due to the headaches, so I won't eliminate that. But after taking it for 2+ years, it doesn't seem to cause drowsiness, etc. Can you suggest anything to help alleviate the fatigue. I live in AZ so I get tested for Coccidioides every 6 months.

Response from Mr. Molaghan

Hello Thank you for such a complete medical history. I know it can be frustrating when all " the numbers look good" and you feel so wiped out. You mentioned that your free testosterone level was 9.2; was this result within the normal reference range for that laboratory? Although you've probably built up a bit of tolerance to the MS Contin, it is stilling a central nervous system depressant, and may cause some symptoms of fatigue. Although I don't know your history of antidepressant treatment, it might be helpful to discuss the effectiveness of the Paxil with your doctor. There are some antidepressants that have more stimulating effect than others. Some patients have been treated successfully with Ritalin for severe fatigue. You and your physician should have a discussion about these options. Nutrition is one area that seems to be neglected by many people with HIV. Eating smaller frequent meals during the workday also helps.


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