Sorry to be a pest but I'm striving to get to a more complete understanding regarding multiple symptoms my partner is having. I have several questions here as well beyond simply issues with leg cramping too. My partner began having constant cramps in his calves about a year ago. This was discussed with our doctor. In subsequent visits the doctor implied that the growing symptoms were either simply daily strain or psychosomatic, imagined. Hmmm?..... However the problem continued to grow steadily worse and it was discussed at the appointments every three months. never to be adequately addressed or looked into. In a previous question-to-answer, I was given by Dr Henry, the scenario that possibly the AZT in Combivir may or might be the culprit to the leg cramps but that the general population have issues with leg cramps.... Is the "general population" the public at large or the HIV general public. How long after cessation of Combivir, or AZT, to another Nuke free HAART regimine, would it take generally before there was lessening of muscle pain caused by the AZT? 48 hours, a week, a month, or many months to even a year or more? ...or never at all. I know each individual reacts differently but I believe there might be some general rule of thumb that might be suggested to resolution if at all possible. Now I'll note that there was a problem with the lab that was running all the labwork for the group of doctors in our clinic. The lab was proven to have falsified lab results and was also caught not maintaining sanitary testing conditions in which there was high potential for cross contamination of lab results. It's now public knowledge beyond just our clinic and all one has to do is ask any pharmacist or medical professional about this lab and the flood gates open to conversation about how much errant information came out of this lab. That said our clinic is still using this lab for it's testing results! Our doctor ran muscle enzyme tests to rule out muscle damage from AZT, recently. Those test results came back from this lab negative...... On to my next question. My partner was initially diagnosed with encephalopothy. The initial "presumed" prognosis was that he would have permament motor damage, along with short and long term memory retention problems. The motor damage happened. However the presumed memory prognosis was anything but as had been initially thought it would be. My partner has seemingly better memory than I do and he's proved me wrong too many times to count regarding my own memory about things I have mis-stated of miscommunicated about. Sure we had the initial issues of "prompting" I'd fallen victim to inducing in general comunications before he began his HAART regimine. Subsequent to his initial recovery period of 3 months in a lock down nursing home, when he was back home I began to see marked memory improvement very quickly as he got steadily better. Here we are 7 years later and in a phone conversation with our doctor this afternoon the doctor noted to me that my partner has troubles remembering things. This from a man who only sees this patient once every three months and for only about 30 minutes at best even then. And he passes this edict as gospel???!!!?? My partner and I had noticed "problems" with our doctors attention to care and being able to maintain control in the many areas he's involved in, two years ago. We asked him directly, then, how he could be involved in so many things and still maintain his effectiveness in all areas. At that time he admitted to us openly that he was failing at maintaining attention to patient care as well as all the other areas of responsibility he's in charge of. This doctor is in charge of a research department, teaches classes, handles several hundred patients in a rotating caseload every three to six months, and also has hospital rounds every day with residents in tow, and all that atop of the voluminous paperwork from each of these positions he's in charge of. He openly and honestly admitted to failure in all areas adn his innability to delegate! There have been health issues we've both brought to his attention going back two or more years that are only now beginning to be addressed to finding resolution because my partner has begun to loose ground health wise regarding ignored symptoms brought to our doctors attention and also because my partner ended up in the hospital for a week because of what appeared to be a heart attack. Our doctor recently had both of us in for a 2 1/2 hour office meeting to go back through my parners records to correcting incorrect notations and to clarifying further the growing and debilitating symptoms my partner has been experiencing. He started off the office visit in handling us with kid gloves like I've never seen out of anyone before to striving to keep the meeting calm and openminded to finding answers. He also initially appoligized for his lax care prior to this meeting. So I think to myself that he's stating that my partner has memory problems when he has no routine interaction on which to base such a statement and it's quite the opposite scenario or I believe, with defference to our doctor, "projecting" on his part. Our doctor seems to be way to diluted to be effective and I am seriously concerned. I have many many more questions that are spin-offs to all this but will stop and await your consideration and answers. Understand that I'm not angry at our doctor because he is incredibly tallented and has done so very much to bring my partner back from the brink of disaster. I'll also note that my partner has become the poster child for an unbeliveable recovery beating the odds in the inital prognosis and odds stacked against his recovery to where he is today. We have been seriously considering changing peacefully and respectfully to another staff doctor within the clinic who isn't stretched to a snapping point with way too many demands on their time. I look foreword to your response and thank you sincerly for all your efforts. B

The general population in my previous answer refers to the HIV- general population. Many HIV specialists in the US anyway are overworked and underpaid and can't even cover expenses due to low reimbursement so that is a general problem (as is primary care in general for many of the same reasons). If a patient in not satisfied with a doctor' care then switching to another provider is a very reasonable move to consider. KH