Stephen J. Schueler, M.D.

Acquired Immunodeficiency Syndrome Home Care

Home care for HIV infection and AIDS can be broken down into three important areas:


HIV Medications
Here are some important points regarding your HIV medications:
  • Taking your medication is the most important thing you can do to help control your HIV infection.
  • HIV medications work best if you take them exactly as directed by your doctor.
  • Taking your HIV medications can reduce your risk for life-threatening infections.
    • Your doctor may prescribe prophylactic antibiotics.
  • Some people stop taking medication when they are feeling well. It is important to continue your medication, even when you feel well.
  • Some people stop taking medication when they start to feel worse.
    • During those times, it is important that you continue to take your medication and contact your doctor. You may simply require a change in the dose or type of medication.
  • Talk to your doctor before you take any additional medications or supplements, because they may interfere or interact with your HIV medication.
  • Contact your doctor if you have run out of your medication. Make it a habit to refill your prescription one week before your prescription runs out.
  • Contact your doctor if you do not understand how to take your medication.
  • Contact your doctor if you think you are experiencing a drug side effect.

HIV Treatment Monitoring
Blood tests:
  • You should have blood tests for HIV viral load and CD4 count every 3-4 months.
  • HIV viral load: measures the amount of virus in the bloodstream
    • Your medication is working properly if your viral load remains low.
    • If your viral load is high, your doctor may change the dose of your HIV medication, replace one of your medications, or add a new medication.
  • CD4 count: measures the number of CD4 white blood cells
    • CD4 white blood cells are part of the immune system, which fights infection.
    • If your CD4 count is low, then your immune system is weak.
    • The CD4 count allows the doctor to monitor your risk for an infection.
    • If your CD4 count is low, your doctor may recommend antibiotics, in order to prevent an infection.

Doctor visits:
  • It is important to see your doctor every 6 months, even if your blood tests look good.
  • During the visit, your doctor may detect medication side effects, or signs that your HIV infection is worsening.
  • Your doctor may change your medication before your illness is out of control.
  • You may require more frequent visits if your HIV infection is worsening or difficult to control.

General Tips for Controlling HIV Infection
Find out what 11 things you can do right now to better control your HIV infection.
  • Make sure you receive all of your vaccines:
    • Vaccines protect you from infections that could be life threatening.
    • Your doctor will recommend a pneumonia vaccine (Pneumovax) every 5 years.
    • Your doctor will recommend the new flu vaccine every fall.
    • Your doctor may also recommend vaccinations against hepatitis A, hepatitis B, and Haemophilus influenzae type B.
  • Avoid smoking.
  • Avoid the use of alcohol.
  • Avoid the use of illicit or recreational drugs.
  • Eat a healthy diet that allows you to maintain a body mass index (BMI) over 25.
  • Ask your doctor if vitamins or supplements are right for you.
  • Avoid foods that may increase your risk for infection:
    • Avoid unpasteurized dairy products, raw eggs, raw seafood, and undercooked meat.
  • Drink pure water:
    • Bottled water
    • Filtered water must pass through a reverse osmosis system.
  • Be careful with pets:
    • Ask someone else to clean up after your pets.
    • Make sure your pets are up-to-date with vaccinations.
  • Wash your hands frequently:
    • Wash your hands after you use the bathroom, before you touch food, and after you are in a public place.
  • Get regular exercise.
  • Maintain a regular sleep schedule.
  • Consider joining a HIV support group.

Acquired Immunodeficiency Syndrome Anorexia

Many patients with HIV infection and AIDS will suffer from anorexia.

Anorexia is a problem in AIDS that affects the body's hormones, digestive system and brain, these regulate your appetite. Adequate nutrition is an important part of AIDS treatment, because it boosts the immune system.

Home care for anorexia includes:

  • Avoid stomach irritants such as aspirin or ibuprofen.
  • Avoid excessive caffeine and other stimulants.
  • Check with your doctor about drinking alcohol.
  • Do not force yourself to eat at standard times. Eat when you are hungry instead.
  • Concentrate on eating a healthy diet. Avoid junk foods.
  • Select healthy, high-calorie foods that you enjoy.
  • Eat more frequent, smaller meals.
  • Get some exercise every day.
  • Keep a daily log of your weight.
  • Don't smoke. Nicotine can suppress the appetite.
  • Ask your doctor or nutritionist about dietary supplements.
  • Ask your doctor if any medications you may be taking can cause anorexia.
  • Take any prescribed medications as directed.
  • Anti-nausea medications:
  • Appetite stimulants:

Acquired Immunodeficiency Syndrome Depression

Home care for depression in someone with HIV infection and AIDS includes:

  • Avoid alcohol.
  • Continue daily activities such as:
    • Work
    • Normal meals
    • Seeing friends and family
  • Do not abuse drugs.
  • Do not stop antidepressant medications without first talking to your doctor.
  • Eat a healthy well-balanced diet
  • Regular exercise program
  • Keep appointments with your doctor.
  • Take your medications as directed.

Acquired Immunodeficiency Syndrome Diet

A healthy diet in someone with HIV infection and AIDS provides the body with energy, protein and nutrients needed to maintain a strong immune system.

You must consume enough calories to maintain your body weight. When you are ill, you may require twice the number of calories than usual. Weigh yourself daily and record the values in a log, in order to determine if you are consuming enough calories.

You may experience a decrease in appetite, taste changes, nausea, vomiting, or diarrhea. In addition, thrush or mouth sores may result in uncomfortable or painful chewing and swallowing. It is important to know how to make eating easier and to ensure adequate nutrition.

Nutritional Goals in HIV and AIDS

  • Maintain your weight.
  • Consume a high calorie, high protein diet.
  • Take a multivitamin with minerals, but do not take large doses of vitamins.
  • Avoid fad diets.
  • Eat a healthy heart diet:

Tips on Increasing Your Caloric Intake
  • Include 2 or 3 snacks in your daily meal plan
  • Add milk, honey, sugar, margarine, oil and gravy to your food.
  • Add dry milk powder to mashed potatoes, casseroles, soups and pudding.
  • Drink whole milk or half-and-half rather than low fat milk.
  • Spread peanut butter on toast, waffles, bananas or apples.
  • Use sour cream, mayonnaise, whipped cream and jelly.
  • Add cheese to scrambled eggs, sandwiches, hamburgers, and vegetables.
  • Snack on nuts, cheese, hard-boiled eggs, and hard candies.
  • Try instant breakfast drinks or supplements:
    • Boost
    • Ensure

Acquired Immunodeficiency Syndrome Pain in Adults

Medications commonly used to control pain and inflammation in adults with HIV infection and AIDS include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Acquired Immunodeficiency Syndrome Pain in Children

Common medications used at home for pain and fever in children with HIV infection and AIDS include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Acquired Immunodeficiency Syndrome Stress

Tips to manage stress with HIV infection and AIDS:

  • Accept what you cannot change.
  • Allow yourself to cry.
  • Allow yourself to experience simple pleasures that give you joy.
  • Ask for help if you need it.
  • Associate with people you enjoy and who treat you well.
  • Avoid drugs and alcohol.
  • Do not be dominated by one thing, such as work or relationships.
  • Do not feel guilty when you have to say "no" to extra duties or tasks.
  • Donate some of your time in order to help others.
  • Energize your body with regular exercise.
  • Engage in hobbies.
  • Fuel your body with healthy foods
  • Have the courage to be imperfect.
  • Make a list of all the stresses that cause you distress: dispose of the ones you can and reduce your exposure to the others as much as possible.
  • Practice relaxation and meditation.
  • Reevaluate and rearrange your priorities.
  • Schedule time for fun. Laughter dissolves tension.
  • Seek professional help when you are overwhelmed.
  • Stay on a regular sleep schedule.
  • Take a few minutes of quiet time each day.
  • Take responsibility for how you feel.
  • Talk with someone you trust.
  • Avoid stimulants, such as:

Acquired Immunodeficiency Syndrome Taking Control

The successful treatment of HIV infection and AIDS requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Acquired Immunodeficiency Syndrome Warning Signs

Continue to Acquired Immunodeficiency Syndrome Prevention

Last Updated: Nov 30, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

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