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Anxiety about lymph node pain and depression
Nov 7, 2011

I'm a 51 year old male, diagnosed 2 years ago. I've been on Atripla for almost 2 years now and I'm undetectable but my T-cell count has been hovering in the low 200's (low of 146 before meds to a high of 254, now back down to 220). My doctor tells me that he's not too concerned since I'm otherwise very healthy. At my last visit I asked whether Atripla was the best drug combination for me. Only after pressing the issue he suggested that I consider a change in meds to see whether my T-cell count would improve. One option he suggested is the new quad pill awaiting FDA approval.

I live a very healthy lifestyle and have no liver or kidney problems. I've never missed a dose (only occasional lateness). I'm concerned about occasional recurring lymph node pains under my arms. I have a constant fear that my weak immune system leaves me vulnerable to HIV related cancers or illness'. I also suffer from bouts of depression which at times leaves me feeling hopeless and suicidal (not that I would harm myself).

Any advice would be greatly appreciated.

Thanks for all the great advice and information in this forum. It really keeps me sane!

Response from Dr. Fawcett

Selection of your medications is best made between you and your physician. The anxiety and depression you mention do need to be addressed. It's not unusual for someone to become preoccupied about various physical symptoms. While they need to be discussed with your doctor, the anxiety they create can often be reduced. One technique that is effective is to simply catch yourself when you begin to project worries about all the "what ifs?" I know that is often easier said than done, but it is important not to let your worries get too far ahead of the reality. Convert that anxiety into energy toward getting the facts and then focus on what you can control (sometimes that's simply keeping your thoughts in the here and now.

I'm very glad you stated that you would not harm yourself, but when I hear someone describe hopelessness and feeling suicidal it raises significant concern. I would recommend finding a therapist with whom you can discuss these feelings. Support groups are also effective for dealing with feelings of anxiety and depression. You may find that taking action to get involved in therapy and a support group, along with medication, will begin to reduce your anxiety and depression.

Take care,

- David



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