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a) Is there anything I can do for the weekend while I contact my hiv specialist, i.e. what I can do to manage the disease and avoid getting weaker and lose more weight?
b)Do you think it is a bug/parasite instead of apendicitis or something else?

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replied February 19th, 2008
HIV and AIDS Answer A3664

List of pre-existing conditions: HIV + benign disrrythmia for 1 1/2 months (had Holter monitor and found it was the benign type - I can't remember the name at this moment but will see a cardiologist in 2 weeks

List of other diseases, conditions, or injuries and their treatment: Kivexa, Reyataz and Norvir for HIV one daily dose for the past 1 1/2 years. CD 4 380 and viral load undetectable. Last test
almost 3 months ago and results have been constant for the past year.

Current medical status: Came back from Mexico (one week there) 3 weeks ago. 5 days ago I starting feeling very bloated after lunch. That evening I had cramps (felt like past stomach flu I had 4 years ago) in my lower abdomen (from belly button and down). Next day that pain was gone but instead I had pain in right side of abdomen (almost a straight line from belly button to the right) that felt similar to when I run after drinking a lot of water. This pain becomes worse when I walk and gets better when I lay down. Bloating has remained since the beginning and increases after I eat but I have been eating very little so I have lost 4 pounds in 5 days. Family doctor saw me and explored my abdomen, he said it didn't seem to be appendicitis but not completely sure. On Day two had blood (not viral or cd test done though), urine and ultrasound done. Everything came back ok, no white cells high, no problem with kidneys, liver from ultrasound. Last night (day 4) I had chills and fever for the first time at 39.5C (or 5 Fahrenheit above normal), felt extremely bloated and the same crampy abdominal pain in my mid-lower abdomen started again. Felt nauseous and vomited once. Kept feeling nauseous and dizzy for several hours. In the morning the fever and abdominal cramps were gone but cramps came back after I had some juice. Pain in right side still and always there. I took a stool sample which I didn’t notice any blood or mucus (I don’t have diarrhea btw) for testing today since I completely forgot about my trip to Mexico and only remembered that yesterday and told my doctor about it. I have also noticed that my heart rate has increased from 60 to 90 heartbeats per minute (relaxed but with a persistent mild headache). My blood pressure used to be 105/70 and now 110/80.

Current medical treatment: not being treated, awaiting how it develops, i.e. were waiting for abdominal pain in right side to disappear or get much worse if it was appendicitis

Chills, fever and an increased body temperature indicates that your abdominal symptoms (cramps, vomiting and bloated stomach) could be due to some type of infection. Appendicitis is one such possible intestinal infections. Inflammation of a mesenteryal lymph node (lymphadenitis mesenteryale) is another option. In both conditions, abdominal pain is usually present without diarrhea. You might also be experiencing some kind of viral intestinal infection. Lack of diarrhea makes it difficult to say that an infection is located in the intestines, however. A microbiological examination of the stool sample can make the diagnosis clearer.

Weight loss (1,5 kg in 4 days) is not too much to be worried about because an intestinal parasite can cause weight loss and sometimes abdominal pain an is accompanied with an increased appetite and stool sample is positive. Fever is not typical for presence of intestinal parasites.

Although you are HIV+, your health condition is fairly good . Therefore, you might be prescribed symptomatic therapy like trospium for the cramps and aspirin for the fever until you contact your HIV-specialist.

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