Friday, October 19, 2007

kearns' personal medical AIDS update: my new g-tube, fat HIVers, occult wasting & stigma



chers—

i write this post to you with my newly-placed g-tube sticking out of my abdomen from a big patch of bleach-white gauze and paper tape, a feeding device to provide me with enough supplemental calories to gain 20 pounds and stabilize there by the end of the year. i’m sore — my doctor threaded it through me endoscopically (puncturing me from the inside out). my favorite kind of operation: the anaesthesiologist added gunk to my iv, and the next thing i knew, the procedure was finished. i went home






back at the end of may (my birthday) i had some kind of bug (aside from HIV) and my weight dropped to 135. there was just not enough of me to go around (and it’s not the first time i’ve been at this weight, though it’s my first time with a food tube).

i set a goal of gaining ten pounds by the end of the summer. started out fine — my weight was up to 143 mid-july. then i pushed too hard & got another bug, & dropped back down again.

i kept expecting to gain weight on 1,000 calories/day, thinking that if it were split up into six teeny daily meals, it would somehow alter the caloric arithmetic. my rational mind fell asleep at the switch, i guess (vanity of vanities, saith the preacher). i need to be clearing 3,000 calories/day, from both oral & tube feeding (this despite the AIDS-meds-triggered diabetes). once i get the intake and weight up, the next step is to stabilize at the weight, followed by weaning from the tube. will also have to make contact with a gym, or find some dumbbells for my room come december.

then i saw the report from kaiser network: Two-Thirds of HIV-Positive People in U.S. Overweight, Obese, Study Says.

. . . Some experts said there could be psychological reasons for the weight gain and that some HIV-positive people might be gaining weight to avoid wasting syndrome. In addition, HIV-positive people are living longer and might be prone to poor eating and exercise habits, the AP/Seattle Post-Intelligencer reports.

“We used to worry that [HIV-positive people] would lose weight and become wasted,” Crum-Cianflone said, adding, “Maybe we should redirect our concerns to making sure they are maintaining a healthy, normal weight.” John Brooks — an epidemiologist in HIV/AIDS prevention at CDC who did not participate in the study — said, “It’s very clear now that HIV is no longer a wasting disease in America” (Chang, AP/Post-Intelligencer , 10/4).

for about thirty seconds, i felt like old dobbin witnessing the advent of the horseless carriage. then i spotted the underpinnings of stigma shaping the article: a cure for AIDS takes a back seat to undetectability.

“some HIV-positive people might be gaining weight to avoid wasting syndrome,” says the report. what dobbin-pucky. they’re avoiding looking like they have AIDS.

in the rest of the world, AIDS is a wasting disease. oh yeah. all those guys — the unamericans, the ones who don’t matter, the skin-and-bones refugee set, dying now worldwide.

contrary to the cdc’s john brooks’ wishful sentiments, in fat america, AIDS is still a wasting disease. why?

quick background: i taught aerobics and was an ACE-certified personal trainer for 20 years — two of my many AIDS-driven expertises. i developed exercise programs specific to the needs of HIVers in several la-area gyms. the basic principle of those programs? total body weight is not a predictor of survivability with AIDS. lean weight is. the fat component of your body weight doesn’t matter, although its increase relative to lean weight can signal an overall deterioration in wellness.

from the body:

Scale weight alone is not an adequate indicator of internal health. When someone loses, gains or even maintains weight, the composition of that weight needs to be frequently assessed and monitored.

If weight gain has occurred, was it in fat or body cell [“lean”] mass? If weight loss has taken place, was it in fat or body cell mass? And if weight has remained stable, has the makeup of that weight changed internally?

HIVers go through a process called occult wasting, defined as a “significant depletion of lean body mass without significant weight loss.” basically, as the disease progresses, you lose muscle and you gain fat, even though it doesn’t show. you can determine your lean and fat cell masses at your doctor’s office with a bioelectrical impedance analysis (HIVers should monitor BIA once a year, or more often when your weight is changing).

but inside each one of those overweight & obese & seemingly happy press-culture HIVers is a skinny PWA like me, a time bomb ticking away.

who’s kidding whom? it’s our national obsession: looks vs. substance. ideology vs. science. fancy vs. fact. (the preacher saith all is vanity)

in the meantime, tube in place, i’m jumping back into my activism. i will be attending nedra kline weinreich’s social marketing university training monday-wednesday october 15-17, 2007 on ucla campus. i have several projects i want to work on there, and i look forward to seeing what other attendees are doing. i am also organizing poetry readings in la-area medical cannabis clinics december 1-2, 2007 — world aids day weekend. this will be the second year. in addition, i have some print projects underway, and maybe t-shirt poetry.

catch you there.

namasté

—rk




Saturday, October 6, 2007

kaiser network: two-thirds u.s. HIVers overweight or obese




Public Health & Education | About Two-Thirds of HIV-Positive People in U.S. Overweight, Obese, Study Says

[Oct 04, 2007]


About two-thirds of HIV-positive people in the U.S. might be overweight or obese, "mirroring" the total U.S. population, according to a study released Thursday at the 45th Annual Meeting of the Infectious Diseases Society of America in San Diego, the AP/Seattle Post-Intelligencer reports.


For the study, Nancy Crum-Cianflone of TriService AIDS Clinical Consortium in San Diego and colleagues examined medical records of 663 HIV-positive patients at U.S. Navy hospitals in San Diego and Maryland. The researchers considered medication records, how long participants had been HIV-positive and whether participants had a history of diabetes or high blood pressure.


The study found that 63% of participants were either overweight or obese and that 3% were underweight. About 30% of participants who had progressed to AIDS were overweight or obese, the study found. The study did not find a connection between antiretroviral drugs and weight gain. Participants with weight gain put on an average of 13 pounds over 10 years, the study found. In addition, the study found that people who contracted HIV at younger ages, those who had been HIV-positive for a longer time and those who had high blood pressure were at a higher risk of becoming overweight or obese.


None of the participants had "wasting" syndrome, which is characterized by the uncontrollable loss of 10% of body weight, as well as fever and diarrhea. Wasting syndrome was common among people living with HIV/AIDS when the virus was first discovered, the AP/Post-Intelligencer reports.


According to the AP/Post-Intelligencer, the study's findings are "particularly striking" because many of the study participants were in the military or were military spouses, who tend to be in better physical shape than the general population. Earlier research had found that about 40% of HIV-positive people are overweight.

Reaction


Some experts said there could be psychological reasons for the weight gain and that some HIV-positive people might be gaining weight to avoid wasting syndrome. In addition, HIV-positive people are living longer and might be prone to poor eating and exercise habits, the AP/Times reports.


"We used to worry that [HIV-positive people] would lose weight and become wasted," Crum-Cianflone said, adding, "Maybe we should redirect our concerns to making sure they are maintaining a healthy, normal weight." John Brooks -- an epidemiologist in HIV/AIDS prevention at CDC who did not participate in the study -- said, "It's very clear now that HIV is no longer a wasting disease in America" (Chang, AP/Post-Intelligencer , 10/4).

Thursday, October 4, 2007

john james at AIDS treatment news: int'l drug war clashes with AIDS fight




Drug War Clashes With Fight Against HIV/AIDS

Posted: 03 Oct 2007 06:27 PM CDT

Inter Press Service October 3, 2007

John S James

AIDS Treatment News Daily Alerts


"For more than two decades, the Geneva-based International Narcotics Control Board (INCB) has tried to discourage nations from developing harm reduction programmes and other HIV/AIDS prevention programmes. ...


"In March 2007, the INCB made public statements which were widely covered by Canadian media against Insite, North America's only supervised injection located in Vancouver's Downtown Eastside neighbourhood. ...


"Insite presently has over 800 users a day and has, according to 20 peer-reviewed academic studies, reduced public drug use, reduced dangerous syringe sharing, reduced HIV/AIDS and reduced publicly discarded syringes. Overdose deaths have also decreased in the four-and-a-half years it has been in operation. ...


"INCB Board meetings are also closed to the public and no minutes are available. Critics have argued that none of the members of the INCB have expertise in health, international law or human rights."


from http://aids-write.org


stealing your breath to birmingham: citizen journalism at icpoz.three — eleven posts, one sentence, one tale retold (368.1)



insite, located in vancouver, bc, canada, is the only safe injection site in north america. this is an excerpt from the august 31, 2006 insite fact sheet, posted by a nameless “third year bsc. (nursing) student at university of ottawa in collaboration with algonquin college. i had the opportunity to go to insite this summer and really get an idea of the effect this resource has in the downtown eastside community. there were over 800 visits to the site the day before my tour.”


facts and figures (from insite homepage and pers. comm from my tour)

• people using insite are more likely to enter a detox program, with one in five regular visitors beginning a detox program

• over a two year period 4,084 referrals were made with 40 per cent of them made to addiction counseling

• to date there have been over 500 overdoses at insite. thanks to prompt medical attention there have been no deaths.

• daily average visits: 607

• number of nursing care interventions: 6,227

• number of nursing interventions for abscess care: 2,055

• busiest day: may 25, 2005 (933 visits in 18 hours). So, nearly 1000 needles kept off of the street, nearly 1000 instances where a needle was not shared.1000 instances where an individual had the opportunity to access the healthcare system, not only for drug-related treatment but also for mental health, hiv / aids care, pregnancy testing and maternity care, social work services, counseling and peer-support.

from http://protectinsite.blogspot.com/

GRASSrooters: find your federal, state, county & la city reps

chers---

find out who represents you. then start a dialog. voting is like going to church on sundays.

the one-stop la spot: go to http://www.lacity.org/council.htm. scroll down until you see the following form (“MY NEIGHBORHOOD”) in the right-hand column

fill in your address information, click “find,” and achieve enlightenment.(the form below will probably not work. go to the city council site. results below are from entering my address)

namasté

---rk


Top of Form

MY NEIGHBORHOOD

Enter an address or intersection
Ex: 200 N Main St or Nordhoff/De Soto

(find your council district, police station,
fire station, and more...


Bottom of Form

here’s my list:



Elected Officials


City Council DISTRICT 5 JACK WEISS

County Supervisor DISTRICT 3 ZEV YAROSLAVSKY

State Senate DISTRICT 23 SHEILA J. KUEHL

State Assembly DISTRICT 42 MIKE FEUER

US Congress DISTRICT 30 HENRY A. WAXMAN


with other links to everything from trash collection to cable monopoly



Regional Services

Public Safety

Planning/Construction

Other


if you live outside of la city, you might try these links:


US house of reps

http://www.house.gov/


california state

http://www.leginfo.ca.gov/yourleg.html

CA State Assembly Members' Home Pages
CA State Assembly Members' Addresses
CA State Senators' Home Pages
CA State Senators' Addresses

Wednesday, October 3, 2007

paul koretz to run for la city council 5th district seat in 2009

from the paul koretz article at wikipedia



Paul Koretz (D-Los Angeles) announced his plans on August 2, 2007[1] to seek the Los Angeles 5th District City Council seat now occupied by Jack Weiss in 2009. Weiss is expected to run for Los Angels City Attorney against the current City Attorney, Rock Delgadio. It is also widely believed that former Los Angeles City Controller Rick Tuttle will also run for Weiss's seat.


Prior to that Koretz represented the 42nd district in the California Assembly from 2000 to 2006, serving the maximum 3 terms allowed under California term limit law. The district includes West Hollywood, Beverly Hills, Universal City, and the portions of the City of Los Angeles encompassing the Sunset Strip, Hollywood, Hancock Park, Los Feliz, Westwood, Brentwood, Studio City, Encino, Sherman Oaks, and North Hollywood/Valley Village.


Koretz's wife Gail[2] serves as Director of Public Affairs for Kaiser Permanente Los Angeles Medical Center. They have one daughter, Rachel. The Koretz family currently resides in the Beverly-Fairfax District of the City of Los Angeles[3].


please click on this sentnce to view entire wikipedia article.