Peripheral Neuropathy
Some have recognized the physical condition Jack experiences as symptomatic of painful peripheral neuropathy. Indeed, a rudimentary knowledge of this excruciating condition, increasingly associated with AIDS, greatly informed the work on "Jack" and the dynamic in which he lives with Robert. We've included some clinical background information on peripheral neuropathy put together by William Strain of AIDS Project Los Angeles. But it's the experiences of people who struggle with this challenge that are most affecting. AIDS doesn't look like it used to. The incidence of obvious external manifestations, wasting and lesions, in particular, have decreased significantly, while peripheral neuropathy is experienced by up to 40% of people living with AIDS. The condition may be caused by the HIV virus or side effects of some drugs used to treat it and is slow and difficult to treat. It involves a progressive numbing, tingling, prickly then painful sensation in the peripheries (usually toes, then feet and legs) that can crescendo into unbearable, dense pain. Many report the discomfort as piercing and unremitting and it renders a constant tense and unpleasant mood. Yet, to many people close to sufferers of this condition, it remains invisible and something of a mystery. It is an isolating and depressing situation and the oft-heard "but you don't look sick," only exacerbates the frustration. It may be impossible to truly understand the pain without actually experiencing peripheral neuropathy, but an awareness of the condition goes far in helping to empathize with and contextualize the behavior and moods of so many people challenged with this horrific affliction.
Diagnosis and Management of Sensory Neuropathies in HIV Infection