May 29, 2000
I am a 33 year old male who has been living with HIV/AIDS for three years. My current counts are 450 tcell and non-detectable viral load. I was on a combination of combivir and crixivan for an initial three year period and have only recently switched to a combination of Combivir and Ziagen about four months ago which seems to be working well. Recently I went through a Bioimpedence test which showed that my Phase Angle was about 3.7, after consultation with my physician we decided to begin using the human growth hormone, Serostim. It seemed to be working well and the side-effects were mild. The most noticeable difference I saw was a "swelling" in my hands and feet. About three weeks into the treatment I awoke one night with my hands screaming in pain. The pain was similar to the feeling of body parts "falling asleep" and then waking up. It was a very painful experience and I became quite concerned. I spoke to my physician and the nurse who is watching my treatment with the Serostim and haven't received what I deem satisfactory explanations for what is going on...
I have noticed that I have whiteness around the second joint of my fingers and that they continually have a numb feeling when I am not using them. This "symptom" is also evident in the joints where my feet meet my toes although I haven't had any pain in that area I do have a continuous numbness there also. After another bioimpedence test we saw that my weight was up, percentage of fat had lowered, I was not retaining water and that my Phase Angle had lowered to 3.2. I found this to be a little alarming. Since the pain and numbness I have taken a short break from the Serostim but it doesn't seem to help much. My doctor prescribed Celebrex, I guess to help with the pain and as an anti-inflammatory. I would appreciate any information you could provide about what the problem may be. I understand you may not be familiar with the use of Serostim but any suggestions would be greatly appreciated. As always, thank you for you wonderful work. brian
Response from Dr. Fisher
Pain and swelling in joints can occur as a side effect to serostim. You might actually have symptoms of carpal tunnel syndrome (CTS) in your wrists. You might try a different anabolic agent such as oxandrolone to see if you can gain weight/muscle without these symptoms. Also consider an evaluation for CTS...there are non-invasive treatments that can help (such as splinting, exercise).
Alvan Fisher, M.D.
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