RESURRECTING Ritonavir and Testosterone: worth the Hassle THE BODY POLITIC BY _jOHN HANNAH his time, gentle readers, I have but two bees in my bonnet, as related to living with HIV: Ritonavir and testos- ' terone. So, without fitrther ado... Ritonavir They can put a man on the moon, but they can’t put Ritonavir into a pill. Ritonavir is a protease inhibitor used in combi- nation therapy for HIV. Like all protease inhibitors, it packs a wallop with its side effects: nausea, dizziness, fatigue, vom- iting, nerve damage — the usual set of wrench- es in the works of an HIV-positive person’s life. ' But even worse, the capsule form of Ritonavir proved to be chemically unstable. Now the drug is only available in liquid form — a foul,-corrosive li- quid that is easily the worst thing you will ever taste. And if your AIDS cocktail includes it, you will taste it twice a day, every day. I knew what I was getting into when I began taking Ritonavir, of course. Its liquid for- mulation is notorious in the HIV-positive media and has actually gener- ated a lot of discourse, mostly in the ‘helpful hints’ vein. Mixing it with chocolate Ensure, priming your taste buds with peanut but- ter, taking it with yogurt are all popular suggestions. At best, these tactics slightly dilute the unspeakable taste of the stuff. But we take what we can get. After taking the Ritonavir liq- uid for a couple of months, I caved in. I begged my pharmacist and my doctor for an alternative. I couldn’t stand it anymore. The quality ofmy life had been signif- icantly reduced by my twice-daily ordeal. However much peanut butterl crammed into my mouth, hoviever tightly I pinched my nose, the nauseating aftertaste of the liquid would linger for hours. I plunged into gloom whenever I thought of my next dose. You may think I am exaggerating. I am not. Anyone who has tried this throat. stuff knows exactly what I’m talking about. I remembered that my doctor . had once mentioned something to me about putting the Ritonavir _ liquid into capsules myself. He had warned me that it was labor- intensive and time-consuming and probably a big pain in the ass. I had taken his word for it, but after two miserable, poisonous months, I was willing to try any- thing. My doctor was right; filling my own Ritonavir capsules is a big pain in the ass. Each gelatin capsule ($15 for 100, which insurance won’t cover) needs to be filled with a syringe — a very delicate operation. Each 5ml dose takes six capsules to accommo- date and that takes about 15 min- utes of preparation time. But guess what? It’s easily worth it. I feel like I’m cheating the devil every time those six cap- sules slide down my throat. I still grapple with the sideeffects of Ritonavir, of course, but the expe- rience of taking it has been down- graded -from a genuine horror to a mere inconvenience. I want to get two things across A to two different groups of people. If you are HIV-positive and tak- ing Ritonavir orally, I strongly encourage you to try putting the liquid into capsules yourself. If you are an AIDS practitioner, Psst! There's more to read in OITM besides No kidding! Dykes To Watch Out For! please take my word for it that this medicine tastes as bad as we say. Get your HIV-positive patients to try filling their own capsules. Living'with HIV is hard enough without fouling your sense of taste twice a day. Testosterone Yes, that’s right. Testosterone I feel like I ’m cheating the devil every time those six capsules slide down my again. Since writing about my positive experience with testos- terone supplementation, quite a few people have asked me for more" infonnation about it. So, in keeping with the theme of pains- in-the-ass-that—are-worth-it,I thought I’d regurgitate a few nuggets for your consideration in the space of this column. Scientific studies have linked low levels of testosterone in HIV- positive men to depression, fatigue, and diminished sex drive. If you are experiencing any of these, you might want to have your testosteroiie levels checked. It is important that your test is done correctly. To accurately gauge the levels of the hormone in your blood, three samples must be taken at 20-minute intervals. The samples are then combined and measured for testosterone content. This elaborate procedure is necessary because men’s bod- ies naturally secrete quickly fluc- tuating amounts of the hormone. ‘ As long as. yOu’re having blood drawn anyway, you should probably get your cholesterol level checked, too. Protease inhibitors have been shown to elevate cholesterol and testos- terone can also sometimes boost it, so you and your doctor should monitor your relative levels care- ’ fully. Now that people are living longer with HIV, we need to attend to the long-range conse- quences of our medical treatment. Testosterone is available either through injection or in patch form. The shot is medium- painful, but the patch is awkward to apply and difficult to keep in place. My partner and I get nurse’s appointments at the Community Health Center every other week for our shots. They even keep our testosterone for us, so we don’t have to worry about storing it. If you want to undergo testos- terone supplementation, however, you must commit yourself to get- ting shots regularly and without fail, as well as rigorously moni- toring your testosterone and cho- lesterol levels. Like putting Ritonavir in capsules yourself, it’s a bother, but you might feel much better if you do.V OUT IN THE MOUNTAINS — MARCH 1999 — 17 MAGGIE FRAMPTON MSW ACSW LICENSED CLINICAL SOCIAL WORKER PSYCHOTHERAPY - CONSULTATION ADULTS - ADOLESCENTS PROFESSIONAL CONFIDENTIAL MONTPELIER, VT (802) 229-5071 Practice limited to male clientele THERAPEUTIC MASSAGE William Coil, NCMT fit 802-658-2390 800-830-5025 v KAISER FERMANENTE _ PIIOIIE: 802/524-9595 §~'"r7a, Community 1:“; 302/524.2357 : Hmlth I7l.1n mu; : H m.n~.I I-.Ir NORTHEAST DIVISION Carol Thayer, M.D. PO Box I160, RD2 ' Fairfax. V!‘ 05454 Michael Gigante, Ph.D. Psychosynthesis Counseling, Psycliotlierapy, 8 Consultation » ( 802) 254-8032 15 Myrtle St., Brattlelaoro, VT 05301 email nzgigante@together.net RICK RECCHIO. MD.. FAAP. specializing in (‘l£l0l(’SL‘(’lll and pediatric nzvdical care PO Box 806, 184 Rt. 7 South Milton, VT 05468 I (888) 527-8189 rrechiO@together.net Burlington 850-5350 Montpelier 229-5220 JOSIE JUHASZ, M.A. Lic. Psychologist - Master LYNN GOYETTE, M.s., M.A. Lic. Clinical Mental Health Counselor Slb COUNSELING CENTER OF NORTHERN VERMONT sliding fee scale insurance accepted