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My Kind of Life: How I Became My Doctor's Free Continuing Medical Education Provider

For One, Oxandrin Does Not Equal Excedrin

September/October 2005

Carlos A. Perez
I recently lost my position as Editor of the HIV Services Directory that TPAN published for 15 years, basically due to Bush's cuts. I was blessed and found another job during January 2005, as manager at one of the Rapid HIV Testing Programs for Access Community Health Network.

For healthcare coverage I chose the HMO (Health Maintenance Organization), because I couldn't afford the PPO (Preferred Provider Organization).

I know there are people at Northstar Medical Services saying "I told you so," but this choice was based on the pocketbook. Believe me, my HMO does not have the handsome and gay-friendly doctors who know HIV inside and out and gorgeous patients in the waiting area that Northstar is known for (sigh).

HMOs require that I see an Internal Medicine or Family Practice doctor before I can see an Infectious Disease Specialist.

The first time I saw an internist, Dr. So-and-So says, "I am 50 years old and have had this practice all my life and I run a tight ship around here, and I am not going to have my office shut down by prescribing some of these medicines."

I looked at him and said something like "what?" He was treating me like I was some fat, hypocrital, Republican-butt-kissing radio host. I told him that most people with HIV experience nervousness, anxiety and depression, and that's just a few of the mental side effects.

It was back to the HMO doctor-finder. As soon as I uttered "HIV" to the new internist, he said, "You don't belong here. You need a PPO so you can get the care you need. Do you know how much work it is within this HMO to get you to your specialist?"

"Umm, no, I was under the impression that I see you and you refer me to the Infectious Disease doctor and if I show signs or symptoms of any HIV-related illness you can use another type of referral that will let me see the specialist on a regular basis." "Who told you that?" "The customer service people at the 800 number," I replied. "Yeah, well, what they tell you and what really happens are two totally different things," he replied, looking rather upset.

A few days passed and I needed some refills. He called to tell me he had a problem prescribing Oxandrin. He said, "This is a steroid and I do not feel comfortable prescribing steroids." I told him that Oxandrin has been approved by the FDA and has been in use for many years by HIV specialists for their positive patients, especially long-term survivors like myself. "But these steroids are not good for you, haven't you heard the stories about athletes dying from taking steroids?" He sounded very serious and I was thinking, How could he be so ignorant?

I responded, "Yes I have, but these athletes are taking injectable steroids and they are self-administering them in huge dosages equal to more than what an HIV-positive person takes in Oxandrin in one week!" He queried further. "What would happen to you if you stopped taking the Oxandrin? Wouldn't you look and feel okay and maybe be just a little less buff?" I could not believe my ears.

"If I stop the Oxandrin I will start to feel tired in about two days and in about two to three weeks I would lose a lot of my muscle mass, and within six months there is a very good chance that I would lose my lean muscle and then start to lose weight little by little." I paused. "Oxandrin is used to stave off wasting." He did not sound convinced. "I'm going to have to ask the Infectious Disease specialist about this before I approve this prescription. And the Marinol ..." "Uh huh?" I responded. "That's like marijuana," he whispered, as if the DEA was tapping his phone line. "What do you use that for?"

I use it to help me with the nausea and vomiting that can frequently occur as a side effect from my HIV combination therapy. "But there are other drugs you can take for that; have you tried Compazine or Pepto Bismol when you feel nauseated?"

At this point I knew I should be getting paid for all this "free" continuing medical education. "When I feel nausea from the HIV meds, I could take Compazine or Pepto Bismol, but I guarantee you that I will vomit that up with the rest of the contents of my stomach, including my last dosage of HIV meds that made me upchuck in the first place." He sounded grossed out. I wished I could puke on his shiny patent leather MD shoes.

"I will have to confer with your Infectious Disease specialist about these two drugs," he said. Both drugs were finally approved and I quickly signed up for the three-month prescription service by mail.

I recently visited his office for a routine check-up and he left the room with my chart on the desk opened up to the day's notes. Naturally I perused my files. I found his letter to my specialist in which he was asking about the Oxandrin and Marinol. I was really impressed with the specialist's reply; he really knows his stuff and I wish I did not have to go through the HMO red tape and hoops of fire to get to the doctor who understands my medical condition, but I did not make the rules. The best part was how the HMO internist spelled Oxandrin. What he spelled out was Excedrin! I laughed out loud, but quickly gagged myself thinking they'll think I'm mad.

So sign up for your CME courses right here with Carlos A. Perez, because it's my kind of life in your kind of world!

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This article was provided by Positively Aware. It is a part of the publication Positively Aware. Visit Positively Aware's website to find out more about the publication.
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