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Chiropractic Management of the HIV/AIDS Patient. Questions Submitted by Gender Class 2005 Presented by John S. Mosby, B.A., B.S., D.C., M.D. 1. Will AIDS Patients Come Into Our Practice?. What do you think? . YES. How many of you know someone who has HIV/AIDS?
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Chiropractic Management of the HIV/AIDS Patient Questions Submitted by Gender Class 2005 Presented by John S. Mosby, B.A., B.S., D.C., M.D.
1. Will AIDS Patients Come Into Our Practice? What do you think?
YES How many of you know someone who has HIV/AIDS? Or know someone who knows someone with HIV/AIDS? Curtis Day, D.C., Chicago/One of my consultants Large Percentage of his practice consists of HIV/AIDS patients
AIDS Patients Are Diagnosed Earlier Today • Have new medical treatments prolonged the lives of Persons Living With AIDS (PLWA)? • Have the number of new cases leveled off?
HIV Estimate: No One Really Knows • HIV+AIDS Estimate For 2005: Approximately 1,200,000 • 250,000 or more have HIV but don’t know it Reference: National HIV Prevention Conference June 2005 Atlanta
CLINICAL MANAGEMENT:Common Findings in HIV/AIDS Patients • NONE • Expected S/S and Frequency: • FEVER 96% • LYMPHADENOPATHY 74% • PHARYNGITIS 70% • RASH 70% • MYALGIA/ARTHRALGIA 54%
PROGRESSION OF HIV TO AIDS (First noticeable symptoms usually 10 years after exposure unless PEP)
PROGRESSION OF HIV TO AIDS (AIDS usually occurs 7-11 yrs. or more post exposure.) Recommendations for testing:Baseline, 6 wks., 3 mos., 6 mos.
TESTING • Orasure • ELISA-Enzyme-linked immunosorbent assay • Western Blot-used to confirm • P24 Antigen-HIV replication • PCR- Polymerase Chain Reaction-quantity References: CDC AIDS HOTLINE 1-800-342-AIDS, p.1285 CMDT CDC Publication: Frequently Asked Questions on HIV/AIDS
Most Recent Clinical Presentations • MI • Osteoporosis • Lipodystrophy, Lipoatrophy
Answer: • No, Adjust Them
Are There Any Special Precautions That Chiropractors, Their Staff, And Their Patients Should Take While Being Near An AIDS Patient?
Answer • No! • Universal Precautions Apply • Federal Law: Exposure To Bloodborne Pathogens Standards Apply In Certain Situations • Policy Manual • Spill Kit
Precautions • Skin Lesions • Fluid (Especially Bloody) = Glove Up
Last Question Submitted:5. What Are The Risks To Our Other Patients?
Hepatitis B (and C) • Up to 100 times easier to catch than HIV • Unlike HIV, can live outside of body several days
Last Question Submitted:What Are The Risks To Our Other Patients? In Reference To…?
NEUROIMMUNOLOGY • Nerve fibers physically link the nervous system and the immune system • Since the 18th Century medical doctors have relied on the concept that WBCs control immunity • New Concept=Nerve fibers control immune system • Medicine may validate the chiropractic subluxation! Ref: Psychoneuroimmunology, Academic Press 3rd Edition, David Felten, 2001 Slide 33
CONCLUSION No Matter Who Your Patient Is You Have A Lot To Offer Chiropractic Is Your Gift To Humanity Let’s Correct Subluxations And Try To Help All Of Our Patients Enjoy At Least One More Day Of Life Make One More Step Even If It May Be A Little Step Toward Wellness!