Medication Side Effects Coping Strategies

Today's post from psychologytoday.com (see link below) is another advice post from Toni Bernard and one that is particularly applicable to people living with neuropathy. Because most of the drugs prescribed to treat neuropathy symptoms are designed for other diseases, there is often a risk of side effects. These side effects are mainly annoying and  influence the quality of our lives but some are plain dangerous and need to be monitored by your doctor. The point of the article is how do we deal with these side-effects and that frustrating feeling that they're actually not necessary? It's often a question of standing back and looking at the situation objectively but it's never as easy as that. This article gives some helpful hints on how to live with the results of the medications meant to reduce our other symptoms.
 

How to Cope with Side-Effects of Medications
Strategies for weathering the side-effects of prescription drugs
Post published by Toni Bernhard J.D. on Mar 29, 2015 in Turning Straw Into Gold

Many of us who suffer from chronic pain and illness are on medications with side-effects that, in some cases, are as difficult to cope with as our initial health problems. I’ve recently started a medication that I’m scheduled to be on for five years. I’m taking it because it significantly reduces the risk of a recurrence of my recent bout with breast cancer (if you want, you can read about that here).

And so, yes, I’m taking the medication… but I’m also struggling with its physical and mental side-effects. This article is not a substitute for talking to your doctor about any difficulties you’re encountering with a prescription drug. That said, I want to share two strategies for coping with the side-effects of medications.

Start where you are

In my book, How to Wake Up, I write about Pema Chödrön’s practice called start where you are. I describe how it’s helped me make peace with living day-to-day with a number of unpleasant symptoms associated with a chronic illness I’ve suffered from since 2001.

With the help of this practice, instead of mounting a daily—but ultimately losing—battle against those symptoms by telling myself how much I hate them and how I must get rid of them, I say to myself: “Okay. These symptoms are my starting point today: I feel sick and I’m in pain. Now, how can I make the best of this day?” Pema Chödrön’s start where you are enables me to be present for my life as it is and to try and enjoy it, instead of spending my time complaining about a life I can no longer lead.

This new medication has brought along with it a new start where you are challenge for me. In addition to coping with the flu-like symptoms from my longstanding illness, I’m now having to live with half a dozen side-effects of this new drug. Three examples: sleep is even less restorative than it used to be; my right thumb is so swollen and painful in the morning that I can barely bend it for a few hours until it loosens up. (“Joint pain or stiffness” and “Problems with your fingers while gripping” are included on the list of possible side-effects for this medication.)

And I’ve been feeling low mentally. (“Mood changes” is also on the list of possible side-effects.) Despite being chronically ill for many years, I’ve almost always looked forward to the day, no matter how sick I’ve felt. But on this medication, I can feel a change in my mental chemistry. I experience it as a low-grade dread of the day ahead and a lack of motivation, as if I can’t be bothered to do anything. This is very unlike me.

At first, I felt tossed about by these physical and mental side-effects. I was irritable most of the day and complained a lot about the medication, even though I continued to believe that its benefits outweighed the negatives from its side-effects. No doubt about it: I was at a loss as to how to skillfully handle what was happening to me.

Then I remembered Pema Chödrön’s start where you are. I thought about how complaining about side-effects did nothing to diminish them; in fact, it increased my mental suffering. I decided it would be better for me to stop fighting what was happening and to begin treating how I was feeling as my starting point.

I’ve been working on this, and it’s turning out to be more helpful than I’d imagined. This change in perspective has even opened my mind to the fact that no medication’s side-effects are set in stone. My body may adjust to some or all of them (the initial side-effect of shirt-drenching night sweats has already improved). I’d been so busy complaining about the medication that I hadn’t considered the possibility that some of the side-effects might be temporary—despite the fact that the drug information sheet contains that very statement.

If you’re on a medication that has unpleasant side-effects, I hope you’ll try Pema Chödrön’s practice. I’m confident it will feel better than being trapped in anger and resentment over something you don’t control (just like you don’t control having medical problems in the first place). To start where you are, acknowledge how you feel—side-effects included—and let that be your starting point for the day.

Okay, having started where you are, then what? That takes me to my second suggestion.

Find a work-around

As with start where you are, finding work-arounds is something I've been doing for years to cope with the symptoms of my chronic illness. If I have a task that has to get done, such as pruning some bushes, instead of doing it all at once, I make it a two- or three-day project. If I wake up feeling too sick to leave the bedroom, I try to come up with ways to enjoy myself on the bed that day.

Since I'd already been looking for work-arounds with my chronic illness, I decided I should try it with the side-effects of this medication.

I started with my right thumb. Because I’m right-handed, until my thumb loosens up, I’m limited in what I can do. I can’t get the toothpaste cap open, let alone hold onto the cord I use to pull the blinds up in the bedroom. Some days, I can’t hold a pen. When this first happened, I spent my mornings complaining to my husband and resenting the injustice of it all. He was sympathetic and supportive, but this was not pleasant for either of us.

Then one morning I said to myself: “Okay, first, start where you are: your right hand is of limited use for a few hours after you get up. That’s the way it is.” Then I looked for some work-arounds. I discovered I could use my left hand for simple tasks, such as unscrewing the toothpaste cap. I’ve learned to pull the blinds up without using my right thumb. I postpone other tasks until my thumb has loosened up. Life is much more pleasant for me and for my husband since I’ve started working around what I simply cannot do.

Finding a work-around for my low mood has proven to be more of a challenge. How do you work around the feeling that you don’t want to be bothered to work around a feeling?! It took a while, but here’s what I discovered works for me: gentle force. By gentle force, I mean compassionate force, which means I start by acknowledging how hard it is to feel down and motivationless…and how it isn’t my fault. Having done that, I then force myself to start doing something.

Without that initial dose of self-compassion, I don’t think force would work for me. Being kind to myself helps me muster the energy to get going, and once I’m “up and running,” my mood improves. It reminds me of a lawn mower that’s stubborn to start. You have to keep pulling on the starting cord. It may take a dozen times, but once the mower starts, it hums away.

How I came to write this very piece is an example. The idea for it came to me when I’d gotten up in the middle of the night to use the bathroom. Before I started on this medication, when I’d have one of those middle-of-the-night ideas, as soon as I’d I get up in the morning, I’d want to get my thoughts down on paper. But not this time. When I woke up, I couldn’t be bothered to write anything. I felt too down.

It was time for a work-around. First, I acknowledged with compassion how sad this lack of motivation is for me. Then I forced myself to open a document, label it “side-effects of medication,” and type something—anything—about this topic. Having forced myself to do this, I was off and running like that lawn mower; I even enjoyed getting my initial thoughts written down. When it came to editing (and I do a lot of it), I had to go through this same process again—a little self-compassion and a little force—but once I got going, I enjoyed it.

I recently had to use gentle force as a work-around with my friend Dawn. We had a date to meet at a nearby café for an hour. I came close to cancelling, even though I was feeling up for it physically. Mentally, however, I couldn’t be bothered. I didn’t want to see anyone or visit with anyone. Fortunately, I tried a “mental” work-around: I gently forced myself to leave the house and go meet her. I had a great time.

***

So that’s my plan for coping with the side-effects of this medication. If they persist, it may turn out to be a five-year plan (although I will raise what’s happening with my doctor at our next appointment).

If you’re experiencing side-effects from one or more medications, I hope you’ll start where you are and then look for some work-arounds. My heartfelt best to everyone.

© 2015 Toni Bernhard. Thank you for reading my work. I’m the author of three books:

How to Live Well with Chronic Pain and Illness: A Mindful Guide (Fall 2015)

How to Wake Up: A Buddhist-Inspired Guide to Navigating Joy and Sorrow (link is external) (2013)

How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and their Caregivers (link is external)(2010)

Visit www.tonibernhard.com (link is external) for more information.

https://www.psychologytoday.com/blog/turning-straw-gold/201503/how-cope-side-effects-medications

EFFECTS OF HIGH RISK PARKINSONS MUTATIONS ARE REVERSIBLE

Researchers from the University of Sheffield have found vital new evidence on how to target and reverse the effects caused by one of the most common genetic causes of Parkinson's.

Mutations in a gene called LRRK2 carry a well-established risk for Parkinson's disease, however the basis for this link is unclear.

The team, led by Parkinson's UK funded researchers Dr Kurt De Vos from the Department of Neuroscience and Dr Alex Whitworth from the Department of Biomedical Sciences, found that certain drugs could fully restore movement problems observed in fruit flies carrying the LRRK2 Roc-COR Parkinson's mutation.

These drugs, deacetylase inhibitors, target the transport system and reverse the defects caused by the faulty LRRK2 within nerve cells. The study is published today (15 October 2014) month in Nature Communications.

Dr De Vos, a Lecturer in Translational Neuroscience at the world-leading Sheffield Institute for Translational Neuroscience (SITraN), said: "Our study provides compelling evidence that there is a direct link between defective transport within nerve cells and movement problems caused by the LRRK2 Parkinson's mutation in flies."

Co-investigator Dr Alex Whitworth explained: "We could also show that these neuronal transport defects caused by the LRRK2 mutation are reversible.

"By targeting the transport system with drugs, we could not only prevent movement problems, but also fully restore movement abilities in fruit flies who already showed impaired movement marked by a significant decrease in both climbing and flight ability."

The LRRK2 gene produces a protein that affects many processes in the cell. It is known to bind to the microtubules, the cells' transport tracks. A defect in this transport system has been suggested to contribute to Parkinson's disease. The researchers have investigated this link and have now found the evidence that certain LRRK2 mutations affect transport in nerve cells which leads to movement problems observed in the fruit fly (Drosophila).

The team then used several approaches to show that preventing the association of the mutant LRRK2 protein with the microtubule transport system rescues the transport defects in nerve cells, as well as the movement deficits in fruit flies.

Dr De Vos added: "We successfully used drugs called deacetylase inhibitors to increase the acetylated form of α-tubulin within microtubules which does not associate with the mutant LRRK2 protein. We found that increasing microtubule acetylation had a direct impact on cellular axonal transport.

"These are very promising results which point to a potential Parkinson's therapy. However, further studies are needed to confirm that this rescue effect also applies in humans."

Dr Beckie Port, Research Communications Officer at Parkinson's UK, which helped to fund the study, said: "This research gives hope that, for people with a particular mutation in their genes, it may one day be possible to intervene and stop the progression of Parkinson's.

"The study has only been carried out in fruit flies, so much more research is needed before we know if these findings could lead to new treatment approaches for people with Parkinson's.

Parkinson's is a degenerative neurological condition, for which there currently is no cure. The main symptoms of the condition are tremor, slowness of movement and rigidity.

HIGHLY EFFECTIVE NEW ANTI CANCER DRUG SHOWS FEW SIDE EFFECTS IN MICE

A new drug, known as OTS964, can eradicate aggressive human lung cancers transplanted into mice, according to a report in Science Translational Medicine. The drug, given as a pill or by injection, inhibits the action of a protein that is overproduced by several tumor types, including lung and breast, but is rarely expressed in healthy adult tissues. Without this protein, cancer cells fail to complete the cell-division process and die.

When taken by mouth, the drug was well tolerated with limited toxicity. An intravenous form, delivered within a liposome, was just as effective with fewer side effects. Both approaches -- described in the October 22, 2014 issue of Science Translational Medicine -- led to complete regression of transplanted tumors.

"We identified the molecular target for this drug ten years ago, but it took us nearly a decade to find an effective way to inhibit it," said study author Yusuke Nakamura, MD, PhD, professor of medicine at the University of Chicago and deputy director of the University's Center for Personalized Therapeutics. "We initially screened 300,000 compounds and then synthesized more than 1,000 of them, and found a few that were likely to work in humans. We focused on the most effective. We think we now have something very promising."

OTS964 targets TOPK (T -- lymphokine-activated killer cell -- originated protein kinase), a protein that is produced by a wide range of human cancers and is believed to promote tumor growth. High TOPK expression correlates with poor prognosis in patients with breast and lung cancer.

Initial studies of the drug, and a precursor called OTS514, found they were effective in killing cancer cells. But they could disrupt the production of new red and white blood cells, causing hematopoietic toxicity such as mild anemia and increasing the risk of infection. At the same time, the drugs increased the production of platelets, which help in blood clotting.

When the researchers encapsulated the drugs in liposomes -- microscopic bubbles similar to a cell membrane, commonly used to transport drugs within the body -- the drug no longer caused this decrease in red and white blood cells. This approach "completely eliminated the hematopoietic toxicity," the researchers wrote.

They tested OTS964 alone and in liposomes in mice with a highly aggressive human lung tumor known as LU-99. They allowed the tumors to grow to 150 cubic millimeters -- about the size of a raisin -- and then administered the drug intravenously to six mice, twice a week for three weeks. The tumors shrank rapidly and continued to shrink even after treatment stopped. In five of the six mice, the tumors completely disappeared -- three within 25 days of the first treatment and two within 29 days. Mice that received the liposome-coated drug had no detectable toxicity.

The drug also proved effective when taken in larger doses by mouth. Six mice with LU-99 lung tumors were fed 100 milligrams per kilogram of OTS964 every day for two weeks. Again, continuous tumor shrinkage was observed after the final dose of the drug. In all six mice the tumors completely regressed. All of the mice had low white-blood-cell counts after treatment, but they recovered within two weeks.

Although this was a small study, the outcome was dramatic. Seeing these results was a "quite exciting moment," said Nakamura, who stepped down from his role as Director in the Japanese Government's Office of Medical Innovation to join the faculty at the University of Chicago in April 2012. "It is rare to see complete regression of tumors in a mouse model," he said. "Many drugs can repress the growth, but it is uncommon to see them eradicated. This has rarely been reported."

Similar studies of the drug's effects on tumor cells growing outside the body enabled the researchers to videotape the process as the cancer cells died. TOPK appears to play a central role late in cytokinesis, the final stage in cell division. Dividing cancer cells would begin to separate into two new cells, but were unable to fully disconnect, retaining an intercellular bridge.

"Without TOPK the cells can't seem to divide; they can't make the break," Nakamura said. "They can't complete the process. Instead they remain tethered by a tiny bridge. When that finally breaks apart, they can't close the membrane. Everything within the cells spills out, they suffer and then die."

TOPK may provide a good drug target for several types of cancer. This study involved primarily lung cancers, but the gene is frequently upregulated in breast, brain, liver, bladder and other solid tumors as well as certain types of leukemia. The researchers are working with oncologists at the University to begin a phase-1 clinical trial as soon as the fall of 2015.

The Side Effects Of HIV Medications

Today's excellent article from thewellproject.org (see link below) will be interesting to both people new to HIV and those who have been living with it for some time. It sums up, in a well explained manner, the various potential side effects of HIV drugs. Your doctor may not have explained these in such detail, if at all and you may find reading medication box pamphlets a problem without a magnifying glass. The article relates certain HIV medications to neuropathy but it would be wise to remember that the newer medications may also have a role to play and the virus itself has now also been shown to be a relevant cause. Apart from that, your so-called HIV-related neuropathy may just as easily have emerged from nearly a hundred other possible causes. Keeping an open mind and talking it over with your doctor, is probably the best advice.

Side Effects

Updated February 2012

Side Effects and HIV Drugs

Over the years, many HIV drugs have been developed that help people live longer, healthier lives. Like all drugs approved by the Food and Drug Administration, HIV drugs are tested to make sure they are safe and effective in treating HIV. However, HIV drugs can also cause some effects that are different from what they were developed to do. These are called side effects. In most cases, the side effects of HIV drugs are mild, like a headache or an upset stomach. In some cases, however, more serious side effects like liver damage or peripheral neuropathy can occur.

Side effects are most common during the first four to six weeks you are taking a new HIV medication. After your body gets used to the new drug, the side effects usually get better or go away. Other side effects may show up later or last longer. There may also be long-term side effects we do not know about yet. Many of the HIV drugs have not been on the market long enough for us to know all the possible long-term effects.

Being Informed about Side Effects Helps

Each HIV drug comes with information on its most common side effects. It can help to read this information. However, remember that this information lists side effects you might experience, not side effects you will experience. While all HIV drugs can cause side effects, not everyone will experience every side effect of each drug, and not everyone will experience the side effect(s) the same way.

Speak to your health care provider about side effects before starting a new treatment. It will help if you know what to expect and how to handle any problems that arise. Some important points:

• Find out what side effects are possible for any new drug you are taking.
• Ask if there are ways of taking the drug that make it easier to tolerate – for example with or without food or at a certain time of day, such as bedtime.
• Find out if you can treat mild side effects with home remedies, over-the-counter medications, or prescription drugs and have these treatments on hand, especially for common side effects like diarrhea and nausea.
• Ask when you should get medical attention for a side effect.
• Let your health care provider know if you are experiencing side effects, especially if you are taking a drug that may cause a particularly serious problem.

Whether your side effects are considered mild or serious, if they are getting in the way of you taking your HIV drugs (see TWP info sheet on adherence), they are a very important concern. If you do experience side effects, do not just stop taking your medication. Talk to your health care provider, who will help you by suggesting ways to address the side effect directly, changing the dose of the drug, or switching drugs.

Women and Side Effects

Although the total number of side effects among people on HIV drugs does not differ a lot between men and women, some side effects (listed below) appear to be more common in women living with HIV (HIV+) than in men.

This may be due to the fact that women have higher levels of certain HIV drugs in their bloodstreams, even though they take the same doses as men. A woman’s smaller body size, metabolism, or hormones may cause the higher levels. For example, with the protease inhibitor (PI), Norvir (ritonavir), women seem to experience more nausea, vomiting, and weakness than men.

Despite some differences in drug levels and side effects, women seem to benefit as much from HIV therapy as men. No changes in dosing have been recommended for women.

Milder Side Effects

Below is a list of more common, milder effects associated with HIV drugs. Click the available links for more detailed information on the side effects listed.

Nausea and Vomiting

Nausea, or feeling sick to your stomach, is one of the most common side effects of taking HIV drugs. Vomiting, or throwing up, is also very common. Both of these occur when new, unknown substances – like HIV drugs – are introduced to our bodies.

The good news is that, when nausea and vomiting occur as side effects of new HIV drugs, they often get better after the first days or weeks of treatment. However, they can still be awfully unpleasant and reduce the quality of your daily life. Nausea and vomiting can get in the way of your taking your HIV drugs regularly or benefitting from the drugs you take (if you throw them up before they are digested). These side effects can also lead you not to get the proper nutrition your body needs.

It is important that you tell your health care provider if nausea is affecting your quality of life, especially your ability to eat and take medications. It is also important to tell your provider if you have vomiting lasting more than a few days, as that may lead to more serious problems.

Because nausea and vomiting are such common side effects with so many of the HIV drugs, switching drugs is often not helpful. Instead, there are some things you can do to manage nausea and vomiting:

• Eat smaller meals more often. Large amounts of food in the stomach can make nausea worse.
• Eat bland, rather than spicy foods. Bland foods are easier to digest.
• Eat room temperature foods. Very cold or very hot foods can make nausea worse.
• Ginger and peppermint have long been known to ease the stomach. Try ginger ale, ginger tea, or peppermint tea.
• Breathe slowly – in through the nose, out through the mouth. Try to avoid strong smells, like perfume, smoke, incense, or food smells.

If these tips do not work, there are prescription medications to prevent nausea and vomiting (“antiemetics”). Talk to your health care provider about which one would be best for you.

Diarrhea

Diarrhea occurs when you have bowel movements more often than you usually do and/or have very loose, watery stool. Like nausea and vomiting, diarrhea can be unpleasant and reduce the quality of your life. It can also lead to dehydration and malnutrition (not getting enough nutrients from your food).

It is important to tell your health care provider if you have diarrhea for more than a few days so that he or she can find the cause and suggest appropriate treatments.

There are many approaches to treating or managing diarrhea:

• Dietary changes:
  • Increase fluid intake to avoid dehydration.
  • Eat small meals every 2-3 hours.
  • Avoid fatty foods, very sweet or spicy foods, caffeine (found in coffee, chocolate, sodas), ‘roughage’ (lettuce, greens, seeds, corn, bran), raw or undercooked foods.
  • Try the BRATT diet: Bananas, Rice (white), Apples (without peel), Toast (white), and Tea (unsweetened and non-caffeinated).
• Herbal remedies: Chamomile, ginger, and peppermint teas have calming effects on the gut.
• Supplements, including probiotics, L-glutamine, and calcium carbonate
• Over the counter medications
• Prescription medications

For more information on managing your diarrhea, please see our Diarrhea info sheet.

Headaches

Some HIV drugs can cause headaches. These headaches usually go away on their own and are not a sign of a serious condition or disease. However, if you experience severe pain, changes to your vision, dizziness, neck stiffness, fever, nausea and/or vomiting, tell your health care provider immediately, as these symptoms can indicate something more serious. Also tell your provider if your headaches are affecting your quality of life or ability to stick to your HIV drug regimen.

If headaches are bothering you, ask your health care provider if over-the-counter pain relievers like aspirin, Tylenol (acetaminophen), Advil or Motrin (ibuprofen), or Aleve (naproxen sodium) are right for you. You may also consider alternative or complementary therapies to manage headaches.

Rash

Rash is a common side effect of many of the HIV drugs, especially the non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as Viramune (nevirapine) and Sustiva (efavirenz). Rashes are more common and more severe in women. It’s important to check your skin for changes in color or any unusual bumps, especially after starting a new medication.

In rare situations, a rash is a symptom of a severe, life-threatening skin reaction called Stevens-Johnson syndrome. Call your health care provider immediately if you experience a bad rash or a rash together with any of the following symptoms: fever, lack of energy, general feeling of illness, muscle or joint aches, itchiness of the skin, mouth sores, bloodshot or dry eyes, and blisters, especially those that look like “targets,” or “bulls-eyes.”

More Serious Side Effects

Below is a list of less common, more serious side effects associated with HIV drugs. Click the available links for more detailed information on the side effects listed.

Kidney Problems

The kidneys are the two fist-sized, bean-shaped organs that filter blood and produce urine. They get rid of waste and maintain a healthy balance of many substances, including water and electrolytes.

Often, those with kidney disease – especially early kidney disease – do not notice any symptoms. This is why it is important to see your health care provider regularly for lab tests that pick up changes to your kidney function. Symptoms of kidney disease can include: too much or too little urine; urine that is foamy, pink, red, or brown; swollen hands or feet; muscle aches or cramps; fatigue and trouble concentrating.

Sometimes people develop a serious condition called acute renal failure (ARF) in response to certain HIV drugs. ARF happens when serious damage to the kidneys occurs in a short amount of time. ARF can lead to permanent kidney damage.

Liver Problems

Some HIV drugs can cause liver problems. It is believed that women and people over the age of 50 are at higher risk of developing liver problems. Obesity, heavy alcohol use, and other liver problems (such as hepatitis B and C) can also increase this risk.

Some drugs, such as Viramune, can cause an allergic reaction in the liver that increases the liver enzymes in your blood soon after the medication is started. It is important that your health care provider do a blood test to check your liver frequently during the first few months that you are on this medication.

In addition, research has shown that women with more than 250 CD4 cells are 12 times more likely to develop life-threatening liver problems when they start Viramune. Viramune should not be used as first-time treatment in women with CD4 cell counts over 250. Women with over 250 CD4 cells should not switch to Viramune unless there are no other options. Women whose CD4 cells rise to over 250 while taking Viramune do not need to discontinue or switch their treatment.

For more information, please see our info sheet on Caring for your Liver.

Lipodystrophy

The term lipodystrophy is used to describe a number of body shape changes that result from the addition or loss of body fat. While HIV+ men and women both experience body shape changes, women are more likely to experience fat gain in the breasts, stomach, and upper bodies. Lipodystrophy can cause big changes in your appearance. If you are concerned about how you look, speak to your health care provider before making any changes to your HIV drug regimen.

Lipdystrophy also involves metabolic problems such as high blood glucose (sugar) and high lipid levels (cholesterol and triglycerides). The exact causes of lipodystrophy are not known, but may include HIV and/or certain HIV drugs.

 For more information on this topic, see our info sheet on Lipodystrophy and Body Changes.

Peripheral Neuropathy

Peripheral neuropathy (PN) happens when the nerves between the feet and/or hands and the spinal cord become damaged. Like frayed wires that can spark or misfire, these damaged nerves do not send their electrical signals properly. As a result, PN can cause feelings of numbness, tingling, burning, itching, or shooting pain. Some people with PN describe their pain as “holding a lit match to my feet,” or “walking on broken glass.”

PN pain can be constant or occasional, and usually occurs on both sides of the body. Some older HIV drugs such as Zerit and Videx can be toxic to the nerves and cause PN. Unfortunately, there are no approved medical treatments to cure PN. For now, the key to treating PN is to remove the cause and control the pain.

For more information on this topic, see our info sheet on Peripheral Neuropathy.

Lactic Acidosis

Lactic Acidosis is a buildup of lactic acid in the blood. It is a rare but serious complication of some nucleoside reverse transcriptase inhibitors (NRTIs) such as Zerit (stavudine or d4T) and Videx (didanosine or ddI). Women (especially pregnant women), overweight people, and those with a long history of NRTI use are more likely to develop lactic acidosis. Symptoms include fatigue, nausea, vomiting, stomach pain, shortness of breath, and weakness in the arms and legs. If you notice any of these symptoms, call your health care provider right away.

For more information on this topic, see our info sheet on Lactic Acidosis.

Other Possible Side Effects

Taking HIV drugs can also affect your heart and bone health. For more information, see our info sheets on Caring for your Heart, and Bone Disease.

In addition to the side effects listed above, you can find more information on other possible side effects in the Diseases and Conditions section of the TWP website.

Side Effects or Toxicities during Pregnancy

The majority of studies have shown that taking HIV drugs during pregnancy does not increase the risk of birth defects. However, there are certain HIV drugs that should not be used by pregnant women because of potential problems for the mother or the baby.

HIV+ women should not take Zerit (stavudine) and Videx (didanosine) at the same time if they are pregnant. Some pregnant women who took these drugs together developed lactic acidosis, which resulted in deaths. Sustiva (efavirenz) and Atripla (emtricitabine/tenofovir/efavirenz) should also not be used by pregnant women, because their use by women in the first trimester of pregnancy has been linked to birth defects.

If you are pregnant or thinking about getting pregnant, speak to your health care provider about all of your medications to be sure there are no specific warnings for pregnant women.

Taking Care of Yourself

HIV drugs help many people live longer, healthier lives. Side effects are an important factor in determining who stays on their HIV drugs. While the term ‘side effects’ may make them sound like they are not a big problem, if they are getting in the way of your taking your HIV drugs, they may get in the way of your good health. If you are having trouble sticking to your HIV drug regimen because of problems with side effects, speak to your health care provider before skipping, reducing, or stopping your drugs. There is usually something that can be done about it, such as changing the dose of that drug, switching to another drug, or finding ways to treat or manage the side effect directly.

http://www.thewellproject.org/en_US/Treatment_and_Trials/Things_to_Consider/Side_Effects.jsp

THE HEALING EFFECTS OF FORESTS

"Many people," says Dr. Eeva Karjalainen, of the Finnish Forest Research Institute, Metla, "feel relaxed and good when they are out in nature. But not many of us know that there is also scientific evidence about the healing effects of nature."

Forests -- and other natural, green settings -- can reduce stress, improve moods, reduce anger and aggressiveness and increase overall happiness. Forest visits may also strengthen our immune system by increasing the activity and number of natural killer cells that destroy cancer cells.

Many studies show that after stressful or concentration-demanding situations, people recover faster and better in natural environments than in urban settings. Blood pressure, heart rate, muscle tension and the level of "stress hormones" all decrease faster in natural settings. Depression, anger and aggressiveness are reduced in green environments and ADHD symptoms in children reduce when they play in green settings.

In addition to mental and emotional well-being, more than half of the most commonly prescribed drugs include compounds derived from nature -- for example Taxol, used against ovarian and breast cancer, is derived from yew trees, while Xylitol, which can inhibit caries, is produced from hardwood bark.

Dr. Karjalainen will coordinate a session on the health benefits of forests at the 2010 IUFRO World Forestry Congress in Seoul. "Preserving green areas and trees in cities is very important to help people recover from stress, maintain health and cure diseases. There is also monetary value in improving people's working ability and reducing health care costs." she says.

BAD EFFECTS OF CRY

BAD EFFECTS OF CRY

PSYCHIATRIC COMPLAINTS – BAD EFFECTS OF CRY 

In general, cry is treated as an expression of sorrows and grievances.

Eyes alone should be never blamed for crying, since those innocents are squeezed between brain and heart with one’s feelings and needs. Depending upon the cause, intensity and environment, expression of cry commonly differs. The tolerance or breaking point of cry also differs from person to person. Some cry even for trivial, some other won’t cry even for a major loss. Some persons control their tears and cry in their heart with inner feelings and some other would cry as they had ruptured out. The effects of cry too differ from person to person. For some, cry may act as a drain for sorrows and stress, to have clear thoughts and for some other, cry can create more and more clumsy thoughts to give an extreme emotional upset to derail the life train.

Anything excess often bring problems, cry is no way exception. Even though, by the time of birth good cry brings good respiration, intensified and aggressive cry may arrest respiration and can complicate one’s life with respiratory distress syndrome, syncope, panic and with brain damage too. Cry syncope not only occurs in infants, but can also happen in adults too (with extreme emotional upset or after violent cry). Getting fainting after hearing shocking news (i.e. even before starting to cry) is nothing but a series of cry syncope. Women and children are more susceptible to these bad effects and in fact sometimes, gains good claims too with this advantageous (?) cry.

In case of infants, cry is the only way to communicate concerning their need. No one can predict when they would start crying and what for. Parents or caretaker need to provide immediate attention to the violently crying baby to pacify and satisfy them at the earliest or otherwise complications may crop up by anytime. Some kids could not stop crying once they have started it. They may cry until they get tired or get into the sleep. In case of violent cry (in adult or child), commonly adrenaline hormone will be loaded into the blood to cause constriction of blood vessels or arteries to elevate the blood pressure for combating stress. Elevated pressure / constriction of blood vessels caused by adrenaline load can turn hazardous by anytime. So infants or kids should never be left alone. The common bad effects of nagging cry are

• Mental trauma with emotional upset
  
• Anxiety, tension, panic, etc
• Loss of self esteem (when not attended properly)
• Restless sleep / sleeplessness
• Arrest of breath / choking / respiratory distress
• Syncope with blueness of the body
• Seizures
• Cold like symptoms
• Cough and vomiting
• Wheezing
• Buildup of habit like adamant character / cruelty / anger (when cry is often uncared or suppressed)

TIPS AND TRICKS TO AVOID / TACKLE AGGRESSIVE CRYING – Prevention is always better than cure, so never allow a trigger or otherwise one may find difficult to get them stop crying. Proper parental care is very much essential to keep infants / kids in enthusiastic and cheering mood. The parents should comprehend that the crying infants / kids need to be cared, served, distracted and educated in due course to accept the granted offers / offerings. To pacify or to keep calm and comfort babies, following things need to be followed.

• Feed baby at regular time and avoid over feeding
• Care for nature of diets
• Provide them with comfort clothing and bedding
• Give attention to them and play with them
• Care for every complaint then and there consulting a doctor
• Never self medicate them and go for investigations as early as possible in case of any complaints.
• Observe regular bowel emptying and bladder emptying
• Serve their needs with out denying – if it could not be offered, distract them with better offers or otherwise make them to understand.
• Avoid unnecessary travels which make them sleep deprived
• Avoid talking loudly, scolding, beating, pinching, punishing by any means since they often worsen the condition.
• Never tease them to cry or make them angry

TREATMENT FOR VIOLENT CRY – Cry as such cannot be treated with

medicines, since it is not at all a disease. Any how, its bad effects like choking / respiratory distress / causing cold like symptoms / wheezing / headache can be well controlled / prevented with homeopathic medicines / treatment (analysing one’s psychology – in child or adult). On screening out crying children all the way (mentally and physically), ruling out the complication or emergency, homeopathy can provide good solution with its sweet medicines and constitutional approach. With proper treatment, complications can be significantly minimised. The breath taking violent cry can be avoided in future by enhancing tolerance, i.e., after treatment, even though if the child happened to cry violently, there won’t be any choking or fainting or wheezing or any other sufferings. Crying tendency / adamancy can also be altered / lowered with treatment, habit development & distraction / mind modulation in case of growing children.

In the deal of child, children’s friendly homeopathy is matchless. It treats everyone as a different individual and treats them according to their symptom presentations, constitution make up (mental and physical) and feelings. I.e., some babies cries all thro the night and sleep fine in the day, some other babies cries all thro the day and sleep fine all the night and some other cries often through out day and night. Some children may cry in night (in sleep) with brooding for the happenings in the day. Likewise, effects of cry, its intenstiy and needed care also differ from person to person. Some needs consolation, some other need to be left undisturbed. Some babies just wish to be cared in calm environments and some others want to be held, massaged and stroked in midst of music. Some other infant wants to be held constantly. Commemorating child’s nature, homeopathy stands high with its classical individualisation and treatment to rectify everything with remedy. Homeopathy is very safe and free from all sorts of harmful effects since it is given in very minute doses. One more advantage with homeopathic approach is children need not be forced to take medicines (as they love it for its sweet taste) which saves lot of weeping and inconvenience.

Homeopathic medicines commonly indicated for adamant crying character and cry syncope are Aconitum, Bacillinum, Belladonna, Calc carb, Chamomilla, Cina, Cypripedium, Graphites, Hepar sulph, Hyoscyamus, Ignatia, Merc sol, Pulsatilla, Silicea, Sulphur, syphilinum, Thuja, Tuberculinum, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com  / www.drcheena.in

(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)

Unexpected Side Effects Of Chemotherapy

Today's post from webmd.com (see link below) reflects the increase in cancer treatent in the modern world. That's both good and bad news: there may be an increase in cancers thanks to our lifestyles and other factors but it also may mean that cancer is being detected and treated both better and faster these days. People living longer also contributes to the rise in cancer cases - they tend to appear more frequently in later years. Unfortunately one of the common side effects of chemotherapy is neuropathy and nerve problems but there are others and this article may help you avoid being surprised if something happens after chemo sessions. Unfortunately, doctors are not the best at preparing patients in advance for side effects; possibly because there's such a variation and not everybody will suffer from one or all of them.


6 Things You Didn't Know About Chemo
By Camille Noe Pagán WebMD Feature Reviewed by Melinda Ratini, DO, MS

“Chemotherapy.” Just the word may make you remember images you’ve seen in movies or on TV. If you or someone you love needs chemo, is that what you’re headed for?

Maybe, but maybe not. Yes, it will probably be hard and have side effects. But you might be surprised by some of the things people who have been through chemo would want you to keep in mind.

1. “I don’t want to hear about your friend, sister, or dog walker’s chemo experience.”

“One of the biggest things patients complain about is how many people share cancer “horror stories” with them while they’re in the middle of treatment,” says Marisa C. Weiss, MD, author of Living Well Beyond Breast Cancer.

“The individual telling the story may mean well, but usually they’re not thinking before they speak,” says Weiss, president and founder of BreastCancer.org. “The last thing someone going through chemo wants to hear is about how treatment went poorly for someone else.”

Her advice: The minute someone begins sharing, hold a hand up and say, “Thank you for caring, but I don’t want to hear stories about other people right now.” 

2. “The most helpful information didn’t come from my oncologist.”

“Yes, doctors are really important. But when I hear that a friend or family member is going through cancer treatment, I tell them to talk to the nurses,” says Dana Kuznetzkoff, a New York film and TV producer who was treated for lymphoma in 2010. “They’re the ones who will tell you exactly what you need to know, like your hair will fall out on the second day of treatment, or expect to be really tired the day afterchemo.”

She has a simple suggestion. “Listen to other people who’ve been there or who are involved in your care, too. I got good tips from my wigmaker and other women who’d been through cancer treatment.”

3. “It’s not just about nausea and hair loss.”

When Paulette Sherman was treated for breast cancer several years ago, “I was shocked when my toenails fell off,” says Sherman, a psychologist and author living in Brooklyn, NY. “I knew my hair would fall out, but didn’t remember [my doctor] telling me about the nails. It was a little upsetting at first, because it was one more way chemo was affecting my body.”

There are many types of chemotherapy. The side effects you have depend on what kind of chemo you get and how your body reacts to it. Hair loss and nausea are common, but they don’t happen to everyone. It’s also common to have other side effects that people don’t talk about as much, such as trouble with memory and concentration, feeling dizzy, or having pain and numbness during or after chemo.

4. “I don’t want to think about cancer all the time.”

You’re much more than a patient. You’re a person with a full life. Your daily routines -- even the little things -- can hold comfort as an anchor when cancer rocks your world.

Still, you’ll want to be realistic and flexible about it. Sherman often took a day off work the day following a chemo treatment because that was when she felt the most side effects. She worked during the rest of her treatment, though.

“Many people were surprised by that,” she says. “I love my work and get energy from it. It’s different for everyone. But for me, it was important to have part of my life be “normal.” I didn’t want cancer to take over my entire life.” 

5. “I can’t support you emotionally right now.”

Friends and family may be upset about what you’re going through. That’s understandable, but you can’t wear yourself out reassuring them.

“I told the people closest to me, “I’m happy to tell you how I’m doing when I can, but I need to take care of myself. If you need extra emotional support or more information than I’ve given you, please reach out to someone else,” Kuznetzkoff says. While it was hard to do this, “It was crucial for keeping my own stress levels down, which helped me get healthy,” she says.

“I tell patients to have a “point person,” like a spouse or good friend, who can update the people whom the patient wants to keep in the loop,” says S. Adam Ramin, MD, who treats men with prostate cancer. “That way, not every update becomes a difficult or emotional conversation.”

If someone seems to be having a really hard time, you may want to suggest that they speak with a counselor who can give them the support that you want them to have but are not in a position to offer.

6. “Chemo’s over and I feel depressed.”

Your friends and family may want to celebrate the end of your cancer treatment, not realizing that instead of feeling excited or triumphant, you may feel blue, anxious, let down, or even scared. These feelings are normal, especially in ­­­­­the year following treatment.

“During chemo and radiation, you’ve got everyone’s support. When you’re done, people often expect things to go right back to normal for you, when you’re still experiencing mental and physical side effects,” Weiss says.

No need to fake it. Instead, tell well-meaning loved ones you’re adjusting and doing the best you can.

Talk to your doctor about how you’re feeling, too. Counseling (plus medication such as antidepressants, if needed), support groups, exercise, and taking time for yourself can help you feel better and ease back into your post-treatment life.

http://www.webmd.com/cancer/features/things-you-didnt-know-about-chemo

HOMOEOPATHIC REMEDIES FOR THE AFTER EFFECTS OF SURGERY

There are many reasons to have surgery. Some operations can relieve or prevent pain. Others can reduce a symptom of a problem or improve some body function. Some surgeries are done to find a problem. For example, a surgeon may do a biopsy  , which involves removing a piece of tissue to examine under a microscope. Some surgeries, like heart surgery , can save your life.

Some operations that once needed large incisions (cuts in the body) can now be done using much smaller cuts. This is called laparoscopic surgery. Surgeons insert a thin tube with a camera to see, and use small tools to do the surgery.

After surgery  there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery

Homoeopathic medicines are found to be very effective for most of the complications after surgery

HOMOEOPATHIC MEDICINES

ABROTANUM 30- A sense of pressure after operation of the chest for pleurisy or other chest diseases

ACETIC ACID 30- It removes weakness after surgery

CAUSTICUM 30-Retention of urine after an operation

CHAMOMILLA 30-Nausea and vomiting after surgery  due to the by use of morphia

CHINA OFF. 30- Flatulence with pain after an operation. There is no relief after passing gas

COLLINSONIA CAN. 30- It is of special value , when giver before surgery for rectal diseases. Does not allow complications to arise after the surgery

COLOCYNTHIS 30-Spasmodic contractions of the urinary bladder after operation of an orifice , entrance or outlets to any aperature. Agonising pain in the abdomen, compelling the patient to bend double

HYPERICUM PER. 30- Relieves pain after surgery.Often subsides the use of morphine

MILLIFOLIUM 30-For complications after surgical removal of stones

OHOSPHORUS 1000- A single dose given a day before the abdominal surgery will prevent nausea and other distress after the operation

RAPHANUS 30- Post operative, gas pains are removed by the use of this remedy

RHUS TOX 30, PYROGENIUM 30- Post operative complications . Look for other symptoms of this remedy

STAPHYSAGRIA 30- Abdominal pain, after its operation

STRONTIUM BROM 30- It relieves shock after an operation and revives the patient , who may have a cold  with profuse perspiration and other symptoms of collapse

STROPHANTHUS HISP. 30- It may be used with advantage after any operation to remove the weakness occurring from bleeding . It tones up the heart also. 10 drops three times daily

HIV Side Effects Including Neuropathy

Some very good advice and general information in this short video clip from HealthGuru.com. It talks about the most common side effects of HIV and/or HIV medications, including neuropathy.


Description: HIV drugs can have tons of side effects. Find out the most common side effects of HIV treatment by tuning into this video.
Read more at http://sex.healthguru.com/video/side-effects-of-hiv-treatment#L0D606mWl0OqkOQA.99

Living longer with the effects of HIV

Today's article makes slightly depressing reading. It talks about the problems many of us face as we live longer (under successful drug regimes) with HIV. It doesn't mention neuropathy specifically - you'll need to add it in the back of your mind as you read the article - it'll push you right over the edge! However, it is another way of letting you know you're not alone, which does give a tiny bit of comfort when your feet are killing you yet again.

I do take slight issue with the tone of the article. The well-meaning Nancy Travers may have worked with the gay community for ten years but the article comes over as a tad 'preachy'. It's stating the obvious that we need to take care of ourselves and try to live as healthy a life as possible and sometimes we just don't need to be reminded yet again, by a young lady, positively glowing with health (at least in her photo(see link). Then again, I may be guilty of judging a book by its cover and she may also have health problems - if so, sincere apologies!

However, anybody who tells us there are 'rules' for longevity, is sort of asking for trouble from HIV veterans who've seen a fair bit of life and are prepared to give up the health regime for that one reckless indulgence every now and then! The fact that the neuropathy prevents you even doing that most of the time, is not the point.
I'll shut up now and let you read the article:

Living With HIV For Older Americans

People living with HIV today are in a different world than those who were diagnosed even 15 years ago. Although infection with the HIV virus is still very serious, thanks to a healthy life style and proper medication, people who are HIV-positive can now lead largely normal lives for a much longer time. The combinations of drugs available today have allowed many people with HIV to fight infections and stay relatively healthy into old age. Being HIV positive isn't a death sentence anymore. There's a plethora of information out there on how to live well with HIV.

The same rules for longevity apply to people with HIV:

•Cultivate healthy eating habits
•Reduce stress
•Obey physicians' recommendations
•Quit smoking, drinking to excess and using drugs not prescribed by your doctor
•Keep immunizations current. They can help prevent infections
•Get adequate exercise, relaxation and sleep
•Ask your physician for further recommendations and additional help


There are a lot of people living with HIV today who are 60 and older. Unfortunately, they may feel older than their stated age because they are dealing with some of the same problems people much older would suffer. A survey of around 1,000 HIV-positive men and women ages 50 and above living in New York City determined that more than half had symptoms of depression, a much higher rate than others their age without HIV.In addition, most of them had other chronic medical conditions such as arthritis (31 percent), hepatitis (31 percent), neuropathy (30 percent) and high blood pressure (27 percent). Some 77 percent had two or more other conditions. About half had already progressed to AIDS before they'd even received the HIV diagnosis, the report found.Currently, about 27 percent of people with HIV are over 50. More than half will be by 2015, said the report. Due to the special needs of HIV-positive individuals, challenges are on the horizon for public health systems and organizations that serve seniors and people with HIV.

HIV can be a lonely road. According to one report, 70 percent of older Americans with HIV live alone. That's more than twice the rate of others their age. Only 15 percent live with a partner.One possible explanation is that many men and women conceal their condition from loved ones for fear of shame or rejection, whether real or imagined. AIDS- and HIV- related stigma and discrimination refer to intolerance, negative feelings, abuse and mistreatment directed at people living with either disease. This can result in being rejected by family, peers and the wider community; inferior treatment in healthcare and education situations; psychological deterioration; and can negatively impact testing and treatment. The lack of any social or family support increases the chances of requiring expensive outside care, such as home health aides or nursing homes, as HIV patients age.

Many older Americans with HIV are still sexually active, though, and should continue to practice safe sex. While 57 percent of older Americans with HIV said they revealed their HIV status to sexual partners, about 16 percent admitted that they didn't, the report found.

HIV treatment has come a long way in the past 25 years. Today, people with HIV can live long, relatively healthy lives. HIV treatment must now focus on controlling the virus as well as dealing with other health problems that can come with living longer with HIV (such as high blood pressure or diabetes-i.e. normal diseases of aging) and helping people have the best possible overall health. With the right treatment, anyone suffering from HIV can lead a full and long life. Living, and living well, with HIV means understanding all you can about your disease and treatment.

Nancy Travers, a Licensed Clinical Social Worker, specializes in all types of relationships; dating, existing relationships, family relationships, and relationships with friends and business relationships. She also helps her clients overcome anxiety and depression through talk therapy as well as through hypnosis. What sets her apart from many other counselors is that she has counseled in the gay/lesbian community for over 10 years. She also has experience counseling families with elder care issues. Nancy has been in practice for over 15 years and can provide you with the tools you need to approach dating and relationships with confidence. Visit her website at http://www.nancyscounselingcorner.com.


Article Source: http://EzineArticles.com/5601204

http://ezinearticles.com/?Living-With-HIV-For-Older-Americans&id=5601204