Granny Knows Best?

Some of my 30-something male patients are becoming grandmothers'not by changing hormones but by changing roles. Until the arrival of WebMD or TheBody.com, medical information or lore was passed on through the wisest, most experienced caregiver: the grandmother. But sometimes a young, frightened, isolated, newly HIV-positive patient turns to his or her only immediate source of confidential HIV information'a good friend who has been positive for years. Yet often when one has been living with HIV for many years, the basics have long been learned and integrated and are therefore not really retrievable to pass along in a grandmotherly sort of way. So if this happens to you, here is a list I run through. And I usually preface the spiel with a statement such as, 'I know you have heard this all before, but it may have new meaning now that you know you are positive.' (1) Transmission: HIV is not transmitted by casual contact. Yes, you can kiss your nieces and nephews. They can have a bite of your hot dog. Nobody needs to wash your dishes or sheets separately. You can offer someone a taste from that glass of wonderful cabernet you are sipping. (2) Food: You can eat almost anything you want. However, I would avoid unpasteurized dairy. Also reduce sushi and other raw seafood to rare circumstances and only at top-quality establishments. Since HIV seems to burn proteins faster, increase them in your diet. (3) Vitamins: Megavitamins have yet to be proved essential for fighting HIV. If you feel empowered by taking a legion of vitamins daily, do it. If you feel faint at the vision of facing a medicine cabinet of vitamin bottles every day, do not put yourself through the expense. Settle for a good multivitamin and add a B complex and an antioxidant combo. We want this vitamin issue to produce only positive vibes, so do not let anyone talk you into doing something that does not feel right to you. Do not forget the fresh fruits and vegetables. (4) Alcohol and drugs: Anything that interferes with good nutrition and sleep is not good for the immune system. We are here to give you a life, but we cannot tell you how to live it. I believe happy T cells are healthy T cells, but you need to make your own decision about how to have fun and stay healthy. Enough said. (5) Travel: Yes, you can go to see Machu Picchu, the Taj Mahal, and the Sphinx. But I would be careful about trekking far beyond the borders of civilization'like the uncharted rivers of Borneo and mountains of Myanmar. I always tell my patients that if they want to be extra safe, they should take their doctor with them. (6) Exercise: If you have always wanted to train for an Ironman, go for it. But if you have never exercised more than channel surfing, that is OK too. However, from a general health standpoint, this may be the time to start some cardiovascular activity for 30 minutes a day, three days a week. Some of the philosophy of topic 4 applies here. (7) HIV in the news: Do not panic if you hear that a great breakthrough has been reported in Topeka and you live in Toledo. Nothing is going to pass you by. All successful research will eventually reach everyone. (8) Safer sex: Now that you are HIV-positive, you still must practice safer sex with another seropositive person. There is very strong data documenting that an infection with a second strain of HIV can occur. The chance of picking up a resistant virus may be 20% in some communities. Why double that risk? (9) Depression: About 70% of people newly diagnosed with HIV will have some depression. If your spirits drop, you can't sleep, and nothing is fun, then you are depressed. There are lots of resources to help, so do not hesitate to ask. Just remember, when a good friend calls and says, 'I really need to talk to you,' go back to the basics. OK, Granny. You're on. Bowers is board-certified in family practice and is a senior partner with Pacific Oaks Medical Group, one of the nation's largest practices devoted to HIV care, located in Beverly Hills, Calif. He has served on the boards of AIDS Research Alliance and Lambda Legal. He is on the editorial board of Postgraduate Medicine.