Those of you not on meds how did your doctors react

[BootmanLA]

10 hours ago, J0nn1eb0y said:

@bootmanLA and @baresluttybottom 

Doctors do take the hippocratic oath so @bootmanLA your response has some validity.

@bootmanLA Doctors are a business and also have biases and agendas. Case in point the US  has 4-5% of the worlds population yet we consume 95% of ALL prescribed medications. We are the ONLY country which allows "ask your doctor or pharmacist". Big pharma influences many many things. Did all the Oxy's which were prescribed by doctors needed? Probably not. 

I found your allegation about percentages odd, so I did some research. Here's what I found.

1. The commonly cited statistic is that we consume "75%" of prescribed medications - not "95%". 

2. That itself seems to trace back to a 2011 WHO report, but that report doesn't say what the commonly cited statistic says. Rather, it was looking at the percentage of a HANDFUL of prescribed drugs - not "ALL" prescribed drugs - and those were ones with a high potential for abuse: opioids, amphetamines, cocaine, marijuana, and ecstasy.

3. In much of the world, for instance, marijuana is not a controlled substance or even one that requires a prescription. In the U.S., until very recently, the only way to get it legally was through prescription (and at that, prescriptions that skirted federal law). So yeah, when you're one of the few countries who requires a prescription for Drug A, you're going to have a  high percentage of the worldwide prescriptions for it.

4. A big part of the demand for amphetamines is people who don't actually need them, but who like the effects, and compliant doctors write the scripts. That's not a medical doctor agenda; that's a consumer agenda.

5. Ditto for opioids. There's a serious overprescription problem for opioids, but it's not because doctors want everyone taking opioids; it's because we have hundreds of thousands, if not millions, of people addicted to them, and unscrupulous doctors are milking that for money. Again: it's not a medical doctor agenda; it's a consumer agenda fed by doctors willing to skirt or outright break the law.

6. Finally: we have pretty damned good reporting of distribution and use of medications in this country. Not enough people are looking at the data, but it's there. I'd argue that very few countries in Africa, South America, or Asia have anywhere near as accurate a set of records, and I suspect drug consumption there is dramatically under-reported in the official numbers.

And again: this is only for a handful of types of drugs - not counting antibiotics, statins, blood pressure meds, HIV prevention and treatment, blood thinners, and scores of other categories of drugs.  In many countries, drugs that we keep as prescription-only (like antibiotics) are widely available over the counter. So it's impossible to do any sort of apples to apples comparison in prescription consumption. Ours is undoubtedly higher than many, if not most, but that's also partly a product of being one of the (overall) wealthiest societies on Earth. A $10 monthly supply of a generic statin is within reach of a huge portion of the US population, if needed; that's not the case in Bangladesh or big parts of India or central Africa.

[ejaculaTe]

PozGingerPubes wrote:
I Like the health insurance that I have, and don't want to be on their bad side, yet I am sure they are not going to be thrilled with my No meds, choice; I know my primary physician is pissed at me, for being Positive, when she thought I was prescribed Prep. 

 

Three months of Genvoya has a list price of about $11,000 (at least according to Express Scripts - whether Express Scripts actually pays that price or gets a discount is something I don’t know). So the insurance company pays now by paying for meds or later when you develop various and sundry infections. 

Edited October 8, 2020 by ejaculaTe
formatting snafu on my iPad

[BootmanLA]

On 10/8/2020 at 11:46 AM, ejaculaTe said:

PozGingerPubes wrote:
I Like the health insurance that I have, and don't want to be on their bad side, yet I am sure they are not going to be thrilled with my No meds, choice; I know my primary physician is pissed at me, for being Positive, when she thought I was prescribed Prep. 

 

Three months of Genvoya has a list price of about $11,000 (at least according to Express Scripts - whether Express Scripts actually pays that price or gets a discount is something I don’t know). So the insurance company pays now by paying for meds or later when you develop various and sundry infections. 

Unless, like some people allege on here, they'll just let themselves die before they take any meds. Personally I think very few actually go through with that - this place is full of people who live fantasy lives on this forum - but to the extent such idiots exist, they don't end up costing their insurers that much. (of course, depending on how widely they infect others, they could be responsible for a hell of a lot of costs for other people).

[Guest FinalDL2021]

On 10/5/2020 at 12:06 PM, backpackguy said:

PozGinger, maybe it's time to find a new doc...preferably gay. I have Blue Cross/Blue Shield PPO as my health insurance. Sure, a little more pricey but it "opens all doors!" I get my all my health care from Stanford (University) Health. A year ago I had to change docs since mine went into medical administration. I took the opportunity to ask for a gay doc. I am now in Stanford's LGBTQ program w/a gay doc...best decision I made in a long time. I talk freely w/no holding back unlike my previous straight doc. And yes, like you, I live in the SF Bay Area! We are blessed that there are a good amount of gay docs in the Bay Area.

Thanks for that good advise.  I recently got my full diagnoses through Kaiser: I Have HIV1 which they say is the common strain. My current VL is 46k, my CD4 is 17.  they put me on 3 different meds, yet the one that comes to mind is Descovy. I think I will go this route, until I can navigate this new terrain better, in the future 

[Guest FinalDL2021]

On 10/5/2020 at 12:06 PM, backpackguy said:

PozGinger, maybe it's time to find a new doc...preferably gay. I have Blue Cross/Blue Shield PPO as my health insurance. Sure, a little more pricey but it "opens all doors!" I get my all my health care from Stanford (University) Health. A year ago I had to change docs since mine went into medical administration. I took the opportunity to ask for a gay doc. I am now in Stanford's LGBTQ program w/a gay doc...best decision I made in a long time. I talk freely w/no holding back unlike my previous straight doc. And yes, like you, I live in the SF Bay Area! We are blessed that there are a good amount of gay docs in the Bay Area.

I had the opportunity to switch Health care plans and switched to blue Cross/ Blue shield, and looking into Stanford health. My meds where making me dizzy, or light headed, and I don't need that in my line of work. so I stopped taking them. 

[drscorpio]

Moderator's Note: How about next time you see someone violating a rule, you just report it instead of quoting the post making more things that need to be removed. 

[bihairy]

On 10/10/2020 at 7:03 AM, LateBloomer68 said:

Thanks for that good advise.  I recently got my full diagnoses through Kaiser: I Have HIV1 which they say is the common strain. My current VL is 46k, my CD4 is 17.  they put me on 3 different meds, yet the one that comes to mind is Descovy. I think I will go this route, until I can navigate this new terrain better, in the future 

FYI I think Descovy is for PrEP not for those HIV+

[SpectreAgent]

1 minute ago, bihairy said:

FYI I think Descovy is for PrEP not for those HIV+

Descovy is one of my two prescribed meds. 

[bihairy]

3 minutes ago, RawPlug said:

Descovy is one of my two prescribed meds. 

Oh, that is very interesting..  Thanks I learned something!

[SpectreAgent]

1 minute ago, bihairy said:

Oh, that is very interesting..  Thanks I learned something!

I’m in the UK - I don’t know if that’s the norm elsewhere. 
 

[BootmanLA]

Descovy is used on its own for PrEP, but when used to treat someone who's already HIV+, it's customarily paired with another HIV medication. 

Descovy consists of two medications (emtricitabine and tenofovir alafenamide fumarate), both of which are nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs, or “nukes”). This type of medication blocks the HIV virus from copying its genetic material (which is RNA) to DNA.

Some of the single-tablet regimens for HIV treatment include both of these, along with a third medication from a different class of HIV drugs. For instance, Biktarvy (which I'm on) includes these two plus bictegravir, which is an integrase strand transfer inhibitor  (ISTI). That component blocks integrase, which is an enzyme HIV needs in order to insert its genetic material into a cell's genetic material. 

Atripla, another common multi-drug pill, combines the two meds in Descovy with efavirenz, which is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It uses a different method to block the HIV virus from copying its RNA to DNA from NRTIs.

Genvoya contains the two Descovy meds plus elvitegravir (INSTI) andcobicistat, a CYP3A inhibitor (which is kind of a "booster" drug that helps the others work more efficiently). However, I believe that's the compound that can make Genvoya less kidney-friendly than some other combo pills.

Not every combination of all the various FDA-approved component medications is available as a single tablet, so sometimes a patient will need to take one pill to get, say, two of the compounds plus a third pill that is strictly a third component that you can't get in a single dose tablet. 

[sdcigarpig]

I am not sure.  Though he may freak, when I do go back to see him.  I lost my health insurance, so I lost the ability to get ahold of medications.  And since I know that if I am on medications, that I should be getting blood draws and seeing a doctor all of that went away.  

[wood]

On 10/10/2020 at 6:03 AM, LateBloomer68 said:

Thanks for that good advise.  I recently got my full diagnoses through Kaiser: I Have HIV1 which they say is the common strain. My current VL is 46k, my CD4 is 17.  they put me on 3 different meds, yet the one that comes to mind is Descovy. I think I will go this route, until I can navigate this new terrain better, in the future 

I’m not telling you what to do, but a cd4 of 17 is really low... that’s the point where if you want to be around in the next year, it’s time for them. 

[BootmanLA]

22 hours ago, sdcigarpig said:

I am not sure.  Though he may freak, when I do go back to see him.  I lost my health insurance, so I lost the ability to get ahold of medications.  And since I know that if I am on medications, that I should be getting blood draws and seeing a doctor all of that went away.  

Oregon has had expanded Medicaid since long before the ACA offered a way for states to put most of the cost on the federal government. Between it and the ACA, you should be able to get coverage no matter whether you're jobless or at a very low income (via Medicaid) or via the ACA with your premium subsidized (perhaps heavily) if you're making above the Medicaid cutoff.

Separately, there are also Ryan White Act funded programs in essentially every state to ensure that people who are HIV-positive can get and remain on treatment. Unless you WANT to have unchecked HIV, there shouldn't be too many obstacles in Oregon to being covered.

[sdcigarpig]

Yeah, unfortunately, while it looks good on paper, however, there are complication.  I applied for such, went through the hoops.  As I am working, and married, what I got told:  I am denied, too much money.  

It did not matter that my spouse is disabled, and is on full SSD, SSI, and medicare.  And when this happened, I was told NO, I could not get in on the ACA due to it being in March, it was not considered a serious enough event to go on through there.  

And as far as Ryan White, lets just say that is all handled through another organization, Care assist in the state of Oregon.  And they do not cover primary health care doctors.  

Which by the way, in the state of Oregon, one needs in order to see an HIV specialist.  No primary health care doctor, means no specialist, which means no medication.  

And the only organization in the state of Oregon, that deals with HIV, lets just say from my experience, it is far better to try to help yourself rather than go through this organization, as they did not lift one finger to help, did not try to get me help, rather they let me fall through the cracks in the system, as I was in the grey area.  Then freak out when I am forced to ration my medications, and have my HIV unchecked.  That is my experience in the state of Oregon, still on going.  

So since I have to help myself, it meant me redoubling my effort and praying I make it until March, when I can get benefits with a new job.  That I landed.