Herbal Health – information on herbal medicine

Your options for medical care will depend on where you live. The kind of care specific to HIV infection is likely to be better in a big city: most big cities offer many options for treatment of HIV infection. Smaller cities and rural areas are likely to offer fewer options, and the physicians in these areas are likely to be less familiar with HIV infection. This is because most of the people who became infected in the early stages of this epidemic lived primarily in large cities like New York, San Francisco, Los Angeles, Miami, and Washington, D.C.; disproportionately fewer people living in smaller cities and rural areas were infected. As a result, physicians who trained or who practice in small cities or rural areas often lack experience in treating HIV infection.     As a consequence, when people with HIV infection who live in small cities and rural areas want medical treatment or periodic consultation about medical treatment, they often travel to the nearest physician or clinic specializing in HIV infection.     The options for medical care may also be substantially fewer for people who belong to HMOs, for people receiving Medicaid, and for people who have limited financial resources and no health insurance. HMOs and city health clinics offer medical services that vary in quality, some very good and some not so good. Some HMOs do not allow patients to see physicians other than those physicians who participate in the HMO, or do so only on a case-by-case basis. People enrolled in those HMOs therefore have no choice in what specialists they see. HMOs can also limit the hospitals people may be admitted to.     The process of selecting among medical options begins with finding out what your finances allow. This disease is expensive, and HMOs, insurance plans, and Medicaid will each pay for some things and not for others. In addition, HMOs, insurance plans, and Medicaid all differ in what they will and will not pay for. Many insurance plans especially restrict the outpatient services they cover. Medicaid covers a broad range of services but reimburses physicians at so low a rate that most physicians refuse to accept patients paying through Medicaid. Many employers offer a choice between joining an HMO or being reimbursed by the insurance company, and you may be able to switch back and forth as your needs dictate. In any case, you need to know your options. You can begin by finding out what your HMO, insurance company, or government medical assistance will allow, and then discussing these issues candidly with your physician or with a social worker.

Headaches are extremely common. In most cases, headaches bother the person who has them far more than they bother the physician who treats them. This is because headaches rarely indicate severe or progressive disease. Most headaches occur when the muscles that cover the top of the skull contract. These headaches, called tension headaches, occur off and on in everyone. They go away either by themselves or with simple drugs such as aspirin, acetaminophen, ibuprofen, or any of a multitude of drugs that contain combinations of these drugs.     A less common but more painful type of headache, called a migraine or a cluster headache, results when the arteries of the scalp contract. These headaches may be severe, may involve only one side of the head, and may occur along with nausea, vomiting, and changes in vision. Such headaches tend to recur and often require prescription drugs that relax the contractions of the arteries.     Another common cause of headaches is a generalized illness such as influenza or infections in the sinuses or ears. Sinus headaches are especially common in people with HIV infection, who frequently have sinusitis.     Finally, headaches may result from certain drugs, including AZT, trimethoprim-sulfamethoxazole, rifampin, ketoconazole, amphotericin B) and acyclovir.     All of these headaches go away by themselves, leave no impairment behind, and do not indicate any serious underlying disease.     Certain headaches, however, require a doctor’s attention. Like other focal neurologic symptoms and like fever and stiff neck (see below), headaches can be a symptom of an infection of the brain or the meninges. Headaches associated with infections of the brain or meninges have the following characteristics:1.  They are unusually severe or last unusually long.2.  Either the character of the pain or the location of pain makes the headache different from headaches the person usually has.3.  They occur along with problems with vision.4. They occur along with weakness of an arm or leg, with dizziness, or with impaired coordination.5.   They occur along with stiff neck, nausea and vomiting, or extreme lethargy or sleepiness.6.   They are severe and occur along with an unexplained fever.     The major infections that cause such headaches in people with HIV infection are toxoplasmic encephalitis and cryptococcal meningitis. Both these infections, as well as a multitude of other infections of the brain and meninges, are relatively easy to diagnose. They are also treatable. A less common cause of headaches in people with HIV infection is lymphoma.*131\191\2*

HIV: ON LIVING-TAKING CONTROL: DIVIDE AND CONQUERCut overwhelming and insoluble problems into manageable, solvable ones. People have various ways of doing this.     Divide problems into those that have solutions and those that do not, and focus on the problems that have solutions. Helen had been thinking about dying and worrying about how her family would deal with her death. She could not annul the fact that her death would create problems for her family, so she decided to solve a smaller problem. “I am a real junk collector,” she said. “I thought, if I died tomorrow, would my family want this twelve-year-old perfume? I’ve pitched out so much I didn’t need. I went through them and laughed and laughed—at the prices, at the styles. I threw out two of my three corkscrews. I threw everything out. My surroundings are so much more comfortable, and now my family won’t have to sort through all that junk.”     Focus on short-term problems. Alan had been angry and depressed because he was just becoming established in his career when he began getting sick. After talking to his counselor and his partner, he decided not to focus on his long-term career goals—”I gave up on rich and famous,” he says. Instead, he makes only short-term goals he knows he can accomplish. He has a kit for a grandfather clock he wants to build. He’d like to learn some Italian. When he accomplishes those goals, he says, he will make some more. He tries not to “get upset if the goals don’t get accomplished.”     What this tactic comes down to is this: avoid looking at the whole picture and trying to solve everything at once. Steven says he lives from one day to the next, and does only what is necessary to get through each day. He says he solves only small problems, one at a time, and trusts they will add up. June says that a caregiver needs to do exactly the same: “I concentrate only on making a particular day better,” she said. “I just don’t bother with the big picture.”     Like Steven, Dean says he has learned to stop worrying about overwhelming problems. He tries to change only what he can: “I always tried so hard to change things I couldn’t. Realistically I can’t change my problems—the only way not to have problems is to be dead. And I can realistically change myself. I forgot I could make myself happy. I am as happy or unhappy as I decide to be. I’m surprised at how happy I am, and it’s not in spite of the problems. There are happy people with problems.” In short, take it a little at a time. Expect of yourself only what is reasonable. Try not to borrow trouble or worry about what might happen or cross bridges before you come to them. Be easy on yourself.*237\191\2*