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Drug Holiday Was a Bad Move?
Nov 7, 2004

After almost ten years of strong drug compliance I began taking meds erratically in March this year and decided on my own to stop them altogether to see how things would go. My labs were marginally off in May and today, October 14, were much worse than expected.

I'm disappointed that this didn't go better. A lot of people I know who are poz seem to maintain their numbers without drug therapy easily. I know not to attach my sense of well-being to lab results, but it's very hard to accept being dependent on meds when others around me don't seem to need them.

My viral load has increased from undetectable to 78,000 in eight months. My cell count is down to 117 from 240. I am going back on the original medication plan this week, so other than obvious need to do that I'd like to hear what you think about this: Mis-steps in stopping medication, the ability to regain lost ground after doing so, and renewed feelings that this isn't something a person can ignore or solve by being optimistic or wanting it to be less important.

Thank you.

Response from Dr. Lee

As humans we often have to learn from our own mistakes rather than heeding history or expert advice. These lessons are often hard. If you had asked me before you discontinued the treatment, I would have offered you the information that people with low cell counts often do not do well with these interruptions because the damaged immune system is being "artificially" supported by the treatment. Folks with higher T-cells (especially who have never been below 300) tend to maintain a bit better and longer during treatment interruption. FYI, I never recommend treatment interruptions without a full understanding of the individual's history of illness and treatment. It is best to rely on experts (such as your doc) to help make these decisions. In this case, it may take some time to regain your cell count, but hopefully a regimen can be found that will control the virus and allow your cells to recover.

Dependency on medication is actually one of the lesser dependencies you may have in life. Consider your dependency on food, sleep and other annoying and time-consuming yet life-promoting activities. There are some much worse things in life than requiring medicine to support your immune system (and thus protect you from some truly horrible infections and even an earlier death). But, enough of philosophy- get back in the saddle and ride!

Be well!

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