Brief Answer:
Top of the morning to you Good sir! As it's morning here as well...wee hrs

Detailed Answer:
Good morning to you good sir....and many thanks for providing yet another opportunity to help make some sense out of things. I've read your general practitioner's note and must commend him on his insights into a potentially complex problem. I believe he is spot on when he mentions the possibility of your ARV meds as being involved in the process of your paresthesias and peripheral neuropathy. Of course, it could ALSO be part of the natural progression of any infectious condition and HIV is certainly no exception, however, most experts agree that the ARV class of drugs and ESPECIALLY THE "d" drugs such as ddC, ddI, and d4T drugs are the worst offenders. If you are on any of these drugs (zalcidabine, Hivid, didanosine, Videx EC, stavudine, and Zent) then, there is an especially good chance that any symptoms you might experience while on these drugs are being caused BY THESE DRUGS as opposed to the HIV bug itself. Make sense?

Now, as to the comment that the doctor made on how 1 use of crystal meth likely DID NOT produce any nervous system effects or damage? Although, the concept of "damage" to the body by any drug is typically taken to be something that happens over time and is also dependent upon amount of drug ingested or processed by the body on a day to day basis....the truth is that even after 1 SINGLE DOSE it has been shown both in human beings as well as lab animals that not only can there be pathological changes in the brain, but there can be dramatic pathological changes (and associated damage) to virtually every organ in the body including nerves in the spinal cord, nerves coursing through the body, nerve terminals within muscles, etc. In short, 1 single hit of meth CAN cause a significant amount of damage to nerves in the central nervous system.

Therefore, it is a fallacy to think that so long as usage is restricted to just a few hits or very short term, low dosage usage that pathological effects will either not happen or can be reversed. Perhaps, that is true in some people but there is no way to predict that sort of thing in an individual. Therefore, 1st time users should know that they may be causing untold damage to many systems in the body within a very very short amount of time and just because one stops using doesn't guarantee the halting of these side effects or changes which often times become permanent.

Notwithstanding, I still recommend, as I did in my first response the assay by laboratory of a number of metabolic tests which if found to be abnormal can be replenished or reversed and HOPEFULLY will lead to an improvement in symptoms.

I agree that imaging studies could be of utility of either the brain or the spinal column and cord itself (most likely the LUMBAR SPINE) and that these tests could also reveal problems that have yet to been uncovered.

Once again, I wish you all the best and hope you can keep me informed as to the outcome of any testing or diagnostics that you are able to get performed so it can be determined if anything can be done to reverse your uncomfortable symptoms.

Be well good sir and let's keep fingers crossed for a speedy and fresh recovery. You definitely deserve the best outcomes!

Cheers lad!

And as always do not forget that I am here for you with further questions or concerns at: www.bit.ly/drdariushsaghafi

This query required a total time of 75 minutes to read, interpret, research, and synthesize an approach and complete response to the patient.

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