DEAR DR. DONOHUE: My nephew, about whom I care very much, told me that he is HIV (human immunodeficiency virus) positive, and I am the only family member to know. He is on medicines called “the cocktail” but goes out once or twice a week and drinks alcohol. I say drinking and medicines don’t mix. I would like your advice. – J.K.

ANSWER:
The cocktail of medicines your nephew takes is referred to as HAART – highly active antiretroviral therapy. The AIDS virus – HIV – is a retrovirus, a category of special kinds of viruses. What happened to diabetes and diabetics with the discovery of insulin is what has happened to people with AIDS since the onset of HAART. It has dramatically increased life span and decreased the deadly infections that follow on the heels of the AIDS virus.

HAART consists of three drugs, each contributing its bit in containing the virus.

The issue of AIDS and alcohol has many ramifications. Alcohol in excess dulls judgment and leads people to risky behavior. Some of the medicines used to treat AIDS have the potential to damage the liver. Alcohol can add to that potential. In addition people infected with the AIDS virus are not infrequently also infected with the viruses that cause hepatitis B and C. If that is the case, alcohol must be strictly avoided.

Moderate alcohol consumption is not a huge risk to most people under therapy for AIDS. Moderate means two drinks a day, a drink being one 12-ounce can or bottle of beer, one 5-ounce glass of wine or 1.5 ounces of whiskey. For women, moderate is only one drink a day of the above alcohol amounts.

To be on the safe side, your nephew should check with his doctor about the advisability of drinking any alcohol. Knowing the exact drug combination your nephew takes, the doctor will be able to make a rational decision about alcohol use.

DEAR DR. DONOHUE: My mother once told me that by adding chocolate to milk, you negate the calcium in milk. I have recently passed this “knowledge” to a friend, who disagreed. Can you offer your advice? I would like to clip the answer and mail it to my friend and my mother. – M.S.

ANSWER:
Your mother is not going to like my answer.

The notion that chocolate antagonizes the calcium in milk has circulated for many generations. Here are the facts: Chocolate has oxalate in it. Oxalate binds with calcium to impede its absorption from the digestive tract. However, milk has lots of calcium, and chocolate has relatively little oxalate. Less than 2 percent of milk’s calcium is bound by oxalate. Most of the calcium in chocolate milk is absorbed. I have to side with your friend and pray that I never meet your mother.

DEAR DR. DONOHUE: In listing ways to fall asleep, alcohol is always mentioned as not being an acceptable method to promote sleep. I find that when I cannot get to sleep, a glass of wine helps me fall asleep. Why do most experts say not to use alcohol as a sleep aid? – R.R.

ANSWER:
Alcohol makes people drowsy. There is no doubt about that. It doesn’t foster natural sleep – sleep that occurs in stereotyped stages. That’s the kind of sleep bodies need for refreshment.

People who use alcohol as a sleep aid almost always waken several times a night. Those wakenings are brief and never make it into a person’s consciousness. They usually make a person feel dragged out the following day, and that is a testimonial to alcohol’s inability to provide normal sleep.

DEAR DR. DONOHUE: I have a good friend who is undergoing chemo for small-cell lung cancer. Exactly what is the meaning of small-cell lung cancer, and what are the implications? – R.T.

ANSWER:
There are four common varieties of lung cancer, each with its own course and response to treatment. Small-cell lung cancer, whose name comes from its microscopic appearance, comprises about 20 percent of all lung cancers. It responds better to chemotherapy and radiation than do other lung cancer varieties.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.