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Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.

The participation of Dr. Renslow Sherer in this Forum is made possible in part by an unrestricted educational grant from Abbott Laboratories.

Ask the Experts about Drug Resistance and Staying Undetectable
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how long can i go without medicine
Mar 21, 2008

I've been positive for 12 years. always undetectable,always the same medicine.Insurance is gone and now i'm a truck driver.Is there a way i can get a prescription without the expensive lab work. I can pay the doctor,and manage the medicine through adap or this other insurance I'm looking at.But I owe lab corp a thousand dollars for one uncovered blood work.I'm thinking I could get married to a girl I know who has insurance through her job.Would that help?I only get home every 2 months,that means by the time I'm covered,then go back for blood work, and then go see the doc,this could take forever.my pills run out in 2 weeks.how long before I start to get sick?

Response from Dr. Sherer

You have a long term problem (and so does our country, when a situation like this can exist), and you have a short term problem.

I am happy to help you with your short term problem. The fax number where I work at the University of Chicago is 773-702-8998 (which is a matter of public information). If you will fax any information that you have available to that number, I will verify your story with your doctor and/or your ADAP provider and refill your presciption until we can figure out the long term problem. The best information would be your doctor's name and phone number, any lab result in the past year, a copy of your prescription or ADAP number, the phone number or fax number of the ADAP vendor in your state, and your identifying information, i.e. name, date of birth, address, and a cell phone number where you can be reached. You may not have any of that information, so if you have nothing else, just fax your name, date of birth, your address (and identify yourself as the truck driver), and your cell phone number, and your doctor's name and phone number, and I will confirm your prescription with your doctor and/or at ADAP and renew it...BUT NOT INDEFINITELY, because that would not be good for your health in the long run.

Some states cover the lab tests that are needed to monitor the effects of ART. Some states have public hospitals where these tests are done at no charge to you. Most states have case managers and case manager organizations that deal with these kinds of problems every day. Have you tried to contact any of them in your state? I understand that you are a working man, but sometimes the best course is to ask questions and talk to people.

Since I don't know what state you live in, I will give you one phone number - in Chicago - where you can at least call to get a referral to such an organization in your state. The AIDS Foundation of Chicago is at 312-922-2322, or on the internet at www.aidschicago.org. Call them today, first, before you have to stop at a public fax machine on your route. There has to be a better solution to this problem than your marrying someone for their insurance, which I do not recommend. There's a good chance that you can find some help with your long term problem with a few phone calls or with some leg work on the internet, which you seem to know your way around. If that happens, send me a fax or send another question to this website to let me (and anyone else who looks at this site) know that you found another way to get your meds.

Mostly, I'm glad that you asked this question on this website. The answer to your last question depends on a few things, like what your current T cell count is, and what it was at it's lowest level. Since even a short term treatment interruption increases the risk of drug resistance, its undesirable. In other words, better than answering this question will be to ensure that there are no interruptions in your supply of antiretroviral therapy.

And, finally, I'll do what I do with all the folks who ask questions on this site, i.e. I'll tell you to talk to your doctor about this problem and how he or she can help you with it at your next visit. Did you already tell your doctor about this? Doctors often can't overcome the limits of our health care system, but they too often have colleagues - nurses, case managers, peer educators, pharmacists, and many others - who can help with this type of problem. Keep trying that option as well.



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