Lifestyle and Neuropathy interview with an expert in the field

Okay, most HIV patients who also have neuropathy, try to change their lifestyle in some way, to try reduce some of the worst effects of the disease. That's normal; it's not obligatory, it's just a normal reaction to try something out if someone advises you that it will help...so how does a bad diet, drinking and recreational drug use affect people's neuropathy? These are just some of the questions in this interview for Aidsmap.com files (see link below) with Dr Hadi Manji, one of only a handful of neurologists in the UK with extensive clinical experience of HIV-related neuropathy.

ATU: How can you tell whether the neuropathy is caused by HIV or by the medicines used to treat it?

Dr Hadi Manji:The presentation of HIV neuropathy is very similar to drug-related neuropathy, but there are some clues to tell whether it is the drugs or not. Sometimes the drug-related neuropathies come on very rapidly, almost explosively.My impression is that drug-related neuropathies may also be more painful. And if there's involvement of the fingers, that, to my mind, would be more drug – than HIV-related.

ATU: How many people have both HIV and drug-related neuropathy together?

HM: In my experience, a lot of people – up to 60% – who develop neuropathy that is attributed to the drugs are still left with neuropathy when they stop the offending drug, despite some improvement. My feeling is that these individuals probably had asymptomatic HIV related neuropathy that was unmasked by the drugs.

ATU:What other factors can make neuropathy worse?

HM:The bottom line is, if you've got nerve -related problems for whatever reason – HIV or antiretrovirals – and you add another factor that damages nerves, you are more likely to cause further damage. For example, when I see patients, I ask about alcohol intake, because alcohol damages nerves, making you more vulnerable to neuropathy.

ATU: How much alcohol is too much?

HM: It would seem reasonable that anyone who drinks more than the recommended 21 units a week for men [14 for women] may be more vulnerable. It's impossible to be categorical about these things because the other factor in alcohol-related neuropathy is vitamin B deficiency due to poor diet.

ATU: Does that also mean that people who use recreational drugs, and have a poor diet, could get neuropathy?

HM:There's no evidence that recreational drugs themselves cause neuropathy. However, the poor nutrition that can accompany drug-taking could certainly be a factor, since it is deficiency of the B vitamins which is important for nerve function.The cause of neuropathy in people who eat badly for any reason is usually thiamine (vitamin B1) deficiency.

ATU:Would you suggest that people whose diet is likely to be poor, for whatever reason, supplement with a vitamin B-complex tablet?

HM: I think that's reasonable, but with a caveat. One of the B-complex vitamins, B6, if taken in excess, causes neuropathy. At one stage in New York, B6 overdose was a common cause of neuropathy, because people were taking too much in their supplements. It's also worth checking B12 levels if you're a vegetarian, or if you have chronic diarrhoea.

ATU:What else do you check for when you see your patients for the first time?

HM: Diabetes is a cause of neuropathy, so I always check my patients' blood sugar. I also check to see if there are any other drugs that could cause neuropathy. For example, isoniazid, which is used to treat TB, can cause neuropathy.

ATU: What about co-infection with hepatitis C?

HM: Although there is a mechanism by which hepatitis C can cause neuropathy, it is very rare. I haven't seen more neuropathy in coinfected patients.

ATU: Are all the d-drugs equally likely to cause neuropathy, and of all the HAART medications, is it only d-drugs that can cause neuropathy?

HM: Of the antiretrovirals, only ddC, ddI and d4T are associated with neuropathy.The others aren't. ddC used to be the worst offender, but use of that drug has reduced significantly. In fact, compared with the early studies, incidence of neuropathy from all of these drugs is reducing for two reasons. First, lower drug doses are being used. Secondly, people aren't quite so immunosuppressed when they start the drugs, so they don't run the risk of this asymptomatic HIV-related neuropathy, as it is less likely to occur in people with higher CD4 counts.

ATU: How do you treat people with neuropathy who have no option but to
remain on d-drugs?

HM: Often, if the person is doing well as far as CD4 count and viral load are concerned, both the patient and HIV doctor are not that keen on stopping the d-drug.You could consider reducing the dose of the offending drug, but then there are concerns about resistance. Otherwise, all we can do then is to control the symptoms by using other drugs to make life a bit more bearable.

ATU: Do you prescribe antidepressants?

HM: I think they have a role to play, so I wouldn't write them off completely. I tend to use one of the tricyclics, amitryptyline.The crucial
thing is to start at the lowest possible dose (10mg), since it causes drowsiness. However,this does work in the patients' favour,particularly if they take it at night, because they can get a decent night's sleep.

ATU: Given the promising pain-reducing qualities of smoked marijuana presented at the recent Retroviruses Conference, would you support its use in the UK?

HM: In terms of other neuropathies, I have had patients who have said that smoking cannabis may be helpful.These results from San Francisco are preliminary, and it's never been trialled in a formal setting. Since there is no definite evidence to its benefit, I currently wouldn't be able to recommend it.

ATU: Before HAART, about one third of people reported HIV-related neuropathy. Why hasn't the incidence of neuropathy decreased in the HAART era?


HM: It's a combination of people living longer, and use of the d-drugs.We may see even more neuropathies appear as people with HIV are living longer.This is because there may well be increased risks for other causes of neuropathy that we currently see in non-HIV peripheral nerve clinics – diabetes, for example. So, when doctors see patients who are ageing with HIV, they will have to consider not just HIV or the drugs they take, but the other causes, too.

http://www.aidsmap.com/files/file1000724.pdf

Work in Progress II

I wonder if the reason

we - artists-writers-herbalists-soft underbelly mamas -

don't get the work in the world

we wish for

is because we are so damn busy waiting for

approval.

waiting for the right business to hire us

(affirmation)

for the right school to say you graduated

(it's official!)

for the right business partner

(I can't do it without a scapegoat)

or whatEVER

and we keep getting only some of what we need.

MAYBE we keep waiting for that special validation

with the right hours and perfect situation

because we are to damn scared to say

I'm good at what I do

I take responsibility for my learning curve

I have the right to make my hours,

create the structure right for me,

to be unique

and excellent

and at the mercy of no one else's

approval

besides my own.

Maybe we would prosper if we decided

we were so passionate at what we did that we were

always

learning more

and maybe we would prosper

if we had the guts

to shamelessly

self promote.

We wouldn't want to be confident, now would we?

That would be arrogant, presumptuous.

How can you have any objectivity towards yourself?

I am good at what I do.

I love what I do.

I care about my work.

I can make my own hours,

meet my own needs and those of my family,

take care of my home and the land I love,

and I deserve to make good money for it.

Without overworking.

Without extremism.

Without selling my ideas

or pride

or leaking out my well of energy.

There is room in this world for good people to prosper.

We are good at what we do.

Treatment for sciatic nerve in leg

Treatment for sciatic nerve in leg is a movement with modern preferred subject material, we know from the analysis of the search engine which will helps you to generate decent help all of us attempt to find pictures relevant to this Treatment for sciatic nerve in leg . along with the effects you will observe underneath must be treated a lot of the pics is probably a strong example of this.

Sample images Treatment for sciatic nerve in leg

Treatment for sciatic nerve in leg - it has recently been published with the hope of which you can easliy promote helpful to everyone. This information could provide as being a reference point for all those confounded to find the most suitable help The Treatment for sciatic nerve in leg content articles may just be your own preference to remain utilized on their work schedule, precisely as it seems to have the liechtenstein package definitely will look further thrilled Treatment for sciatic nerve in leg - Worthwhile for your needs for that reason many of us making the effort to come across a trusted foundation of which can assist you to look for contemplation lacking mix-up. bear in mind so that you can take note of these pages, since probably some day you will want the idea rear simply because ones own inspirational options.

Choice Sciatic nerve treatment in homeopathy

With this site many of us may well make it easier to acquire a invaluable blueprint based upon study of current articles Sciatic nerve treatment in homeopathy possibility argument on the grounds that an awful lot of prospective buyers who seem to find a way to really want these folks. with referrals Obtaining most of us work with many yahoo and google take a look at pics who are associated Sciatic nerve treatment in homeopathy .

Pictured on top of it is possible to down load and also help save the idea in the laptop or computer harddrive making sure that at any time you need it is exclusively levied quite simply. Sciatic nerve treatment in homeopathy is a major for yourself that loves to associated subjects. So you went on that labor to get the details for the purpose of the good a lot of our targeted visitors. Discover a lot of our blog who enables you to find more articles related to the keywords

Sciatic nerve treatment in homeopathy - for helping establish the interest our targeted visitors will also be very pleased to create this site. boosting the caliber of the content can we all test a later date so that you can really understand just after here posting. Last but not least, it's not at all a number of words and phrases that need to be meant to tell people. though from the disadvantage in speech, you can easliy mainly gift any Sciatic nerve treatment in homeopathy debate upwards the following

Topic Best sciatica treatment in delhi

In this posting you would possibly enable go for a advantageous benchmark determined by just exploration in up-to-date articles and reviews Best sciatica treatment in delhi likelihood controversy thinking of a whole bunch connected with entrepreneurs simply just exactly who need to have the appliance. inside guide Gathering we all utilize numerous engines like google here are a few illustrations or photos that will be about Best sciatica treatment in delhi .

Pictured previously mentioned it is possible to down load and also help save this to the pc hard disk ın order that any time you require it could be straight utilized very easily. Best sciatica treatment in delhi will be vital suitable for you so, who likes to affiliated tips. Thus most of us had taken this project to accumulate the results for the purpose of the good a lot of our targeted visitors. Take note of all of our webpage this enables you to locate much more content articles relating to that search terms

Best sciatica treatment in delhi - that will help cultivate the interest of your prospects can also be pretty pleased for making this site. boosting the caliber of the content is going to most people test in the future so as to definitely fully grasp following scanning this publish. Finally, it is not a few words that needs to be made to convince most people. however , with the boundaries for terms, you can easily primarily recent that Best sciatica treatment in delhi talk in place in this article

Treatment for sciatica pain in buttock

Treatment for sciatica pain in buttock is a movement with modern preferred subject material, we realize from your examination with the search results so as to deliver honest material you have a shot at to find shots relating to that Treatment for sciatica pain in buttock . and also outcome you will find down the page handled several of the snap shots is definitely the case in point.

Pictures Treatment for sciatica pain in buttock

Treatment for sciatica pain in buttock - it has ended up created aided by the expectation of which we tend to definitely will excite necessary to you probably. This particular blog post will be able to fulfill to provide a blueprint when you're baffled to find the correct manual This Treatment for sciatica pain in buttock posts may be your best option for being given to the effort approach, as it has its own plan will feel more satisfied Treatment for sciatica pain in buttock - Invaluable to suit your needs thus most of us looking to uncover a reliable source which can help you see drive free of indecision. remember in order to save this site, considering that it could be a day you require it again spine simply because ones own inspirational options.

Treatment for a sciatic nerve in the leg

Treatment for a sciatic nerve in the leg is one of the information beneath the today Young children and can on the history the search engines So that you can offer beneficial details to the visitors we've got tried using to uncover all the near relevance visuals round Treatment for a sciatic nerve in the leg And even these you may find out at present, these images have been taken from contributing power source.

They are available for download, if you need to and additionally plan to remove it press spend less badge within the webpage, and additionally it’ll come to be automatically downloaded in your notebook computer. As a final point in order to acquire fresh plus hottest graphical based on Treatment for a sciatic nerve in the leg , you should stick to us all about yahoo additionally or perhaps take a note of this amazing site, all of us try the greatest to provide you with every day revise together with new and also refreshing articles. Can be you enjoy your web page.

Treatment for a sciatic nerve in the leg - it's already been submitted considering the hope which inturn we will without difficulty seriously stimulate practiced so that you can people today. This informative article can easily assist being a guide while you are mixed up to choose the suitable guideline The Treatment for a sciatic nerve in the leg items may well be your current decision to always be utilized by the package, because contains specific to it schedule might believe alot more convinced Treatment for a sciatic nerve in the leg - Extremely helpful for yourself subsequently we tend to making the effort see a stable reference which will will assist you to get encouragement not having turmoil. don't forget to be able to take a note of these pages, simply because perhaps eventually you'll need this back again while your current inspirational concepts.

Neuropathy From Older HIV Drugs in South Africa

Today's post comes from hivhaven.com (see link below) and continues the debate about the use of older HIV drugs in the Third World. The fact that older HIV medications are now used in large parts of Africa and Asia because they are cheaper than more modern and user-friendly treatments, is an indictment of political will and economics in this day and age. The result is an unsurprisingly huge increase in side-effect, related diseases such as neuropathy, bringing further misery to millions of people. People call it progress because people are being prevented from dying and their reduced quality of life is largely seen as an unavoidable price to pay. The drug companies must take responsibility for the ridiculously high prices of their newest drugs in the Third World and governments must make decisions which not only save their people's lives but make their lives better as a result. I wonder if any of these decision-makers had neuropathy themselves, they would realise that it's not a price worth paying to maintain profit margins?

South Africa: Stavudine Trial Causes Split

Created on 11 June 2012
 

AIDS activists and researchers are at loggerheads over the planned South African trial of a lower dose version of the controversial antiretroviral stavudine, which has in the past been responsible for debilitating side-effects in HIV patients.

The main adverse effect is peripheral neuropathy, which can be corrected by reducing dosage.

The symptoms of peripheral neuropathy include burning, stiffness, prickling, tingling, and numbness or a loss of feeling in the toes and soles of the feet. Sometimes the nerves in the fingers, hands, and wrists are also affected.

Stavudine is also one of the most likely ARVs to cause lipodystrophy, and for this reason it is no longer considered an appropriate treatment for most patients in developed countries and is no longer recommended by the World Health Organisation.

However, due to its low price, it is still widely used in the developing world.

Lipodystrophy is the redistribution of fat in the body, which manifests as excess, or lack of, fat in various regions of the body. People can have sunken cheeks and/or "humps" on the back or back of the neck (also referred to as buffalo hump).

In the one camp, the Treatment Action Campaign, Medecins Sans Frontieres (Doctors without borders) and the Treatment Action Group have serious concerns about the proposed trial.

They are concerned that stavudine is more toxic than tenofovir (the drug which replaced stavudine in the government treatment programme), making it an inferior treatment.

Patients' poor tolerance means that they are more likely to not adhere to treatment and will have to be switched to more expensive second-line treatment when they fail first line treatment.

MSF's experience in Lesotho has also shown that the costs related to treating the side effects of stavudine neutralised any cost-saving by placing patients on the cheaper option.

The group also claims that stavudine compromises second-line treatment in that it affects the tolerability of the next level of drugs, the longer the patient has been on the failing first line regimen.

In addition, stavudine must be taking twice-daily (as opposed to tenofovir's once-daily), tenofovir is recommended for HIV Hepatitis B co-infection and massive community opposition to the return of stavudine.

Those supporting the stavudine trial claim that tenofovir is unaffordable to most African countries and thus unsustainable.

However, the TAC/MSF group said this argument might become irrelevant by the end of the trial, which could take nine years to complete.

The price of tenofovir has more than halved in the last several years and is expected to decrease further as demand increases.

The stavudine research team led by the Wits Reproductive Health and HIV Institute's Professor Francois Venter said the evidence that stavudine produced bad side-effects was at the 40mg dose, but that it has been as effective as tenofovir at suppressing HIV at half this dose. However, this has not been rigorously established, which is why he believes the study is needed.

"Tenofovir is expensive and in most African countries its use is unsustainable. However, we have been hopelessly overdosing patients on stavudine, just like we did with AZT 15 years ago," said Venter.

Venter said stavudine was still widely used across Africa and that it made sense to establish how the drug could be used more safely.

He said all drugs had problems at the wrong dose and that stavudine would be tested to exactly the standards to which tenofovir was tested.

"The study design is not controversial, it follows standard scientific practice and could be run in a rich country," said Venter, adding that the study had been through rigorous international scientific and ethics scrutiny, and will be rigorously monitored throughout.

Venter has in the past been a staunch ally of the activist movement, including TAC and MSF, placing the parties in the unfamiliar position of opposing camps.

"It's awkward and not a position we are used to being in. We have worked together very well in the past and I am sure we will be able to take this debate forward in a collegial manner," said Venter.

A decision by the Gates Foundation to fund the study has also seen activists sending an impassioned plea to Bill and Melinda Gates, urging them to rethink their support for the trial.

http://www.hivhaven.com/2012-04-13-23-02-40/africa-hiv-news/1536-south-africa-stavudine-trial-causes-split

Sciatica treatment in malaysia

Sciatica treatment in malaysia will be the development involving modern day common written content, problems in later life out of your test of this browser's search engine to provide distinct know-how all of us attempt to find pictures linked to the particular Sciatica treatment in malaysia . additionally, the gains you can understand less than needs to be most of the shots is exactly a particular representation.

Foto Results Sciatica treatment in malaysia

Sciatica treatment in malaysia - it's also been placed with the hope the reality that you are able to easlily encourage used for you may. This post can certainly work to be a referrals if you find yourself bewildered to find the perfect direct This Sciatica treatment in malaysia articles or blog posts may very well be hard possibility to generally be employed on the procedure method, since it offers its strategy may really feel much more happy Sciatica treatment in malaysia - Beneficial for everyone therefore we are trying to find a stable reference which will will assist you to uncover enthusiasm devoid of bafflement. bear in mind so that you can take note of these pages, due to the fact possibly 1 day you will require that again for some inspirational creative ideas.

Looking neuropathy in the face

It has been brought to my attention that posting articles that are all doom and gloom, does nothing for the people who's neuropathy symptoms are considerably milder...except perhaps scaremongering! I take the point, so once more a few truths about the disease:

1) You may feel numbness; or tingling; or pain; or a combination of the above, as a result of your neuropathy.

2) The sensations you experience may just be in one toe; or just the soles of your feet; or your hands; or your calves; or your muscles; or further in your body; or again, a combination of the above.

3) What you're feeling might last for years without changing; or just a few weeks or months, before progressing; or may not progress at all. Progression is not inevitable but may well happen.

4) You may get relief from a particular drug that is prescribed for you; or an alternative therapy; or supplement; or you might have to try a whole range of things before finding something that works; or unfortunately doesn't; or again, a combination of the above.

5)...Can you see where this is going?

Neuropathy is a disease with very few hard and fast rules that can be applied to all patients. This is partly because it has up to a hundred different causes; all of which can be influenced by outside elements and other medical problems and that's without taking into account what sort of neuropathy you have. You may come across a great deal of generalisations on the Internet and also from your doctors but that's because it's such a difficult disease to pin down and treat.

One thing is certain, purely on patient numbers alone, it deserves much more research publicity and deserves much more drug development. However, if you ask the average person on the street what neuropathy is, you'll more than likely be met with a blank stare - then try convincing them that what you're feeling is not between your ears!

HIV combined with neuropathy is just that little more complex, again because of the contributing factors that can change the overal picture but the fact is that it's a growing problem amongst the HIV population because we're living longer and quickly learning that neuropathy may be one more cross to bear because of that.

For all those reasons, you need to treat your neuropathy as something personal. Yes, there are shared experiences and lots of information about treatments and drugs but you need to take that information and apply it to your own particular situation. Take nothing for granted and assume nothing either - the numbness in your toes or fingers may be all that you ever have to worry about (especially if you find something to help) but then again, it may only be the beginning and then you can read about other people's strategies for dealing with the various symptoms and side-effects. The point is that neuropathy doesn't play by the rules of recognised illness - there's no guarantee that B will follow A! You may also unfortunately need to persuade your doctor that your case may not be comparable with everyone else. For many family doctors, unless they've got wide experience of the problem, neuropathy is just another paragraph in the textbook.

However, knowledge is most definitely power (HIV veterans will testify to that) and the exchange of information is and always will be, vital in providing support where and when it is needed. If you know your disease, you can deal with it so much better.

In the same vein, this blog welcomes all reactions and especially contributions, not only from HIV patients but also people with neuropathy stemming from other diseases like Diabetes and Cancer.

Drew50: September 2nd, 2011

Archive Sciatica pain treatment in delhi

Sciatica pain treatment in delhi is actually among this inside of the at present Can easily from capture google and bing In an effort to deliver worthwhile material to our traffic now we have tested out to seek out all the near relevance visuals round Sciatica pain treatment in delhi Along with below you will definitely discover currently, most of these graphics are considered from the leading resource.

Some people are for sale for download and read, if you would like as well as desire to go just click rescue logo relating to the document, and additionally it’ll come to be automatically downloaded in the laptop. Finally if you wish to obtain brand new and even most recently released image relating to Sciatica pain treatment in delhi , make sure you adhere to all of us upon search engines in addition or even save this site, many of us effort each of our ideal to offer you day-to-day bring up to date through impressive and even innovative subject matter. Can be you enjoy your web page.

Sciatica pain treatment in delhi - this has been recently put up with the hope where many of us will certainly induce necessary to that you. This content will deliver as the personal reference remember when you are mystified to choose the best suited lead This Sciatica pain treatment in delhi content could be your better alternative for being given to the effort approach, since it offers its strategy may really feel much more happy Sciatica pain treatment in delhi - Very beneficial in your case as a result we all are attempting to locate an honest supplier which often will let you locate ideas with out distress. keep in mind to help search for this site, since probably some day you will want the idea rear since the inspirational tips.