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You are so very special to me...
Sep 11, 2006

Hello once again my dearest friend! Thank you so much for your reply. You have such a gift for having the sun come out on cloudy days! I am so very happy that your brother has beaten the odds and is still here with us. Please send him my love and best wishes. I appreciate very much your reply but have a question about something you wrote. (Sometimes I feel like such a simpleton. Sorry.) You wrote,"Chances are the risk levels are much lower than what you might be fearing. Your pediatric HIV specialist, after examining your child's blood lipid profiles, should be able to explain what level of risk is present." What particular questions should I ask to find out if the risks are lower than what I imagine? He said they were very high, but that he would not worry until maybe 20-30 years down the line when it would be of serious concern. The problem is that I have heard of so many young children, dying of a heart attack while playing basketball etc. and that is why I am so frantic. Everytime I take my boys to play baseball, I worry his heart will stop working because of the high levels of cholesterol and triglycerides and that is despite the fact that he is only 88 pounds and is 4 feet 9 inches tall. I feel like what the doctor is saying is that because he is still so young, I should not worry. I trust you so much Dr. Bob and for me, that is such a huge thing because I rarely if ever trust anyone. From my heart, you are family to me. Sincerely. If you would be so kind as to tell me what specific questions I should ask, I will then relay the info to you so that you can give me your personal opinion. I also looked up the link you sent and I am really trying to make the right diet changes. Thank you so much Dr. Bob. You are such a source of great inspiration to me. You make me feel like anything is possible despite this disease... Despite the guilt that I carry heavily and the way I physically look from using meds that change my appearance. I just want to live for my children. That I can finish raising them especiallly after they lost their dad 10 years ago is something I pray for constantly. I am grateful for every day. I am also grateful to know that you are here for people like us. God bless all the wonderful deeds you do for so many and I look forward to your reply as always. Have a great evening. Sending you all my love, Mommy of three

Response from Dr. Frascino

Hi,

The kids dying of heart attacks while playing sports that you have heard about have nothing to do with HIV, HIV medications or elevated blood lipids. That's an entirely different cardiac phenomenon having to do with arrhythmias, anatomical heart defects and other factors unrelated to the concerns you are currently worried about.

Your pediatric HIV specialist should be able to allay your fears. The information I suggest you discuss with him has to do with levels of "good cholesterol" versus "bad cholesterol" and how these numbers may translate into some type of cardiac risk. He may have already tried to answer this for you by indicating that the risk would not be significant "until maybe 20-30 years down the line." If that's the case, I'd suggest you put your fears to rest. We certainly won't be using the same medications even five years from now that we are taking today. (I'm certainly not taking the same toxic stuff I was taking five years ago!)

There are certainly issues we all have concerns about related to HIV and its various therapies; however, what's important is to keep those concerns in their proper perspectives and always balance the benefits of a particular intervention with its risks. There is no doubt your youngster is doing extremely well and that HIV specialists are well versed in monitoring and, when necessary, treating medication-related side effects or toxicities. Get the information you need, but don't worry unnecessarily about distant risks that most likely will never come to pass, OK?

Stay well.

Dr. Bob



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