Paging Dr. Perfect!

Rodney Rodriguez READ TIME: 6 MIN.

For Gerry Salazar, finding the right doctor came easily; the right one was the first one she encountered and their relationship went on for nearly 10 years. When her doctor had to leave her practice and follow her husband halfway around the world, Gerry had to start over and her search was not nearly as easy the second time.

"The fear for me was not in finding a good doctor," Salazar recalled. "There are plenty out there. The fear was finding the right doctor." That meant a healthcare provider whom she felt comfortable talking to, one she felt would listen to her concerns and take them seriously. One she felt was fighting for her life.

"Living with HIV can be scary enough,"Salazar told EDGE, "having someone on my side helps especially when that person is helping you make the decisions that can save your life."

People living with HIV spend a considerable amount of time searching for the right doctor. Like any relationship, a proper courtship must occur. HIV healthcare providers from across the country provided these tips on how to talk to your doctor, how to make sure your concerns are being met, and making sure your treatment is right for you:

Clear, Concise Communication

"When talking to your provider, realize that ultimately they want what's best for your health," advised Cheri Joce, a San Diego HIV healthcare provider. "You and your provider may have different ideas about what that entails, but if you trust your provider, and keep an open dialogue with them about your concerns, the two of you can come to an agreement on which medications will work best for your lifestyle."

"You can break the ice by either coming prepared with your questions or ask about your doctor's experience with your concerns," added Dr. Joseph Olivieri, an HIV physician at New York University's Medical Center, added. "Good communication is the best tip that any patient can follow when your health is the topic."

Most health clinics these days are busy, and sometimes leave a patient feeling like they didn't get all their needs addressed. "If you think you have a laundry list of health concerns," Joce said, "talk with the office staff before your appointment to see if you can get a longer office visit scheduled with your provider.

"Also, be prepared and write down your top three health concerns, so you are organized and ready to go when seen. If all your items don't get addressed, reschedule another visit to discuss your remaining concerns. It's better to have two visits and get everything taken care of, than to avoid dealing with some health issue that you've been worried about.

Olivieri stressed always being aware of what exactly is going on with your vital signs and what they are saying about your overall health. Even more important, he added, "Goals and targets should be established so you can have a better grasp on what you are working toward."

Lifestyle changes may be necessary. That can include anything from diet and exercise to realizing that a job or family tie is too stressful. And always save some wrap-up questions, Olivieri said. Examples: What else do I need to know? What stumbling blocks should I watch out for in my care?

Your Doctor Has Feelings, Too!

"Humor works well for most patients and for most doctors," advised Joel Gallant, chair of the HIV Medicine Association and author of the book "100 Questions and Answers about HIV and AIDS," recalled. "Present yourself as a person right away, not just a patient who's there to answer the providers' questions.

"Start with a smile and a warm handshake. The provider should want to know about you as a person: who you are, what you do, what kind of support system you have. If you're not asked, inject a little of yourself into the conversation anyway."

Your Health Is a Team Effort

HIV medications can literally be a tough pill to swallow and their side-effects are legendary for all the wrong reasons. But these medicines are prescribed for a reason. Never take your treatment into your own hands. Always discuss them with your concerns with your healthcare provider before taking action.

The days of overly aggressive HIV treatment has passed. Gallant's patients tolerate today's medications much better than in the past.

"People starting HIV therapy today typically take a regimen consisting of 1-3 pills per day, usually given as a single dose once a day," Gallant noted. "These regimens are only 'aggressive' from the virus' point of view. From your point of view, they should be easy, safe and well tolerated. Taking something that's less aggressive than a recommended regimen is a bad idea, as it may lead to incomplete suppression of the virus and drug resistance."

"If improvements are being shown and the virus remains unchanged, it may not be advisable to stop taking your treatment," Olivieri added. "But viruses change sometimes, through mutation, which could call for a stoppage in treatment and possible change to another."

This does not mean, however, that you won't experience side effects or grow tired of the daily regimen. Just keep remembering that active intervention is the only thing separating HIV as a manageable condition and as a potentially life-threatening one.

"Ask questions about importance of compliance and what happens if you miss doses," recommends Joce. "If you are beginning to feel tapped out by taking too many pills, discuss this with your provider before taking a 'holiday' on your own." Stopping and restarting antiretrovirals without professional guidance can allow the virus to mutate, which could ultimately cause resistance to not only the medications you are taking, but an entire class of drugs.

Be sure to alert your provider as soon as you are aware that you are experiencing side effects that are impacting your ability to be compliant, such as diarrhea, nausea or vomiting. If you develop a rash just as you start a new program of meds, alert your healthcare provider immediately; this may indicate an allergy -- or a potentially much more serious side effect.


by Rodney Rodriguez

This story is part of our special report: "Ask the Doc: Special HIV Edition". Want to read more? Here's the full list.

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