Randy Wendelin's HAART Attack
by David Pasquarelli
Editor's Note: This piece is about, not by its subject, actor Rany Wendelin. It came to us as is from its author, David Pasquarelli of Act UP San Francisco. Date of posting is 8/20/01.
Did you see that San Francisco's Bay Area Reporter paid homage in the Arts
section of their most recent issue to actor and porn star Randy Wendelin, who
lost his life last week to coronary arrest? It was reported that the
HIV-positive Wendelin, once a buff bodybuilder and avid promoter of
experimental protease inhibitors, had a sudden heart attack and unexpectedly
died in the arms of his lover. No doubt the obituary will announce this poor
soul died of "AIDS," but at this point I think we all know better. AIDS drugs
were the real killer.
You see, I remember Randy Wendelin. Scowling at Ronnie Burk on Market Street
near the Castro. Throwing objects at Michael Petrelis during a Stop AIDS
Project forum where Petrelis criticized the fraud inherent in AIDS funding.
Or looking drawn and deformed at meetings of the San Francisco HIV Prevention
Planning Council as he attacked members of ACT UP San Francisco for pointing
out the deadly effects of protease inhibitors.
There's no denying Randy Wendelin sacrificed his body to the great AIDS drug
experiment and lost. Even as the pills he popped destroyed and deformed him
he defended them by publicly pronouncing that: "Working out burns off fat
everywhere, so that if your body fat is low, lipodystrophy makes you even
leaner. It's not this terrible, tragic disease. I get hired because I have
character in my face. Losing facial fat can make a man more handsome."
Sure, it does. Look where AIDS drugs and the consequent lipodystrophy got
him. His handsome face is now buried six feet under in a pretty pine box.
Talk about denial!
No, I didn't like Randy Wendelin. He was a particularly shallow member of the
vain and vapid Castro white-boy elite. But now he's dead. And it makes me
realize that, love him or loathe him, he was a human being with talents and
gifts that didn't deserve to be poisoned to death. He had family and friends
that cared about him. Like all of us, he deserved to live a life free from
terror, exploitation, and destruction at the greedy hands of AIDS Inc.
Included below are two media clippings from 1999 and 2000 featuring the words
of dead Randy Wendelin. He was no special martyr. Just another sad victim of
AIDS drug poisoning. One that makes me wonder how much longer we as a gay
community are expected to endure this monstrous HIV madness...
David Pasquarelli
ACT UP SF
=====
San Francisco Frontiers
August 24, 2000
Waste Not, Want Not
-----
Fat, Physique, Face and HIV
By Carlton Elliott Smith
Photos by Tom Bianchi
Cecilia Chung could see and touch the places where her body was warping. She
gained three inches on her waistline without altering her diet. Conscious of
her image, she was working out harder than ever to get back to her shapely
figure but with no success. At the same time, she was losing fat on her face
and arms and legs, causing her to look much less healthy than she felt. "For
a while, it was really depressing to see my body changing right before my
face," she says.
At the time, Chung, who is HIV-positive, was taking three anti-retroviral
medications including D4T, more commonly known as Zerit, which some doctors
believe causes lipodystrophy, a syndrome of abnormal fat distribution. Her
symptoms were classic -- fat wasting in the face and the extremities and fat
accumulation in the abdomen, in the breasts of women and, in rare cases, in
the neck, sometimes called a "buffalo hump." She had many talks with her
doctor about what she could do to reverse the condition. As a transgender
woman taking hormones, she was ineligible for drug trials. She switched to a
different drug cocktail, taking Ziagen, Sustiva and Epivir.
After developing a mysterious rash while on that last regimen, Chung went on
a structured treatment interruption, taking no anti-retroviral medications,
starting last October. Over the months, she's seen and felt improvements: her
digestion has become normal again and her body fat has started to
redistribute itself. "I got my waistline back," she says. "I still have
losses of subcutaneous fat in my arms and legs, but it's not as noticeable
because my body is more proportionate."
Chung is hardly alone in negotiating the wasting that is a common side effect
of living with HIV/AIDS and the medications used to treat it. Throughout the
Bay Area and beyond, people living with HIV/AIDS and their physicians are
seeking to understand lipodystrophy and the best ways to respond to its
effects.
According to Dr. Jeffrey S. Dunham, an immunologist and researcher in
Southern California, recent studies have determined that there are at least
two distinct syndromes: one is the loss of fat related to the category of
drugs including D4T, 3TC, DDI and AZT and the other occurs in patients using
those drugs and one or more protease inhibitors in their highly active
anti-retroviral therapy (HAART) regimen. "In other words, if you take D4T
and/or other drugs in that class, you risk losing fat in the face, arms and
legs," he says. "Add a protease inhibitor and you risk getting fat in the
belly as well." Over time, the wasting effect becomes more pronounced. Additio
nal side effects include fatigue, nausea, liver damage and lactic acidosis,
an accumulation of lactic acid that can be fatal in extreme cases.
Partners Randy Wendelin and Tom Finan both live with the effects of
lipodystrophy. Because they work out avidly at the gym, their experience of
lipodystrophy is that it causes their bodies to look more toned and muscular
rather than disproportionate. This is especially important to Wendelin, an
actor. "Working out burns off fat everywhere, so that if your body fat is
low, lipodystrophy makes you even leaner," he says. "It's not this terrible,
tragic disease. I get hired because I have character in my face. Losing
facial fat can make a man more handsome -- there is no one 'look.'"
Finan says that he has HIV-negative friends who will not date men who seem to
be wasting. He himself was working at The Gap when he noticed he was losing
weight. "My look began to change," he says. "I became very aware of it."
Walking down the streets of Los Angeles or San Francisco, he says that he can
tell who is living with the disease and who isn't. "The look is a very drawn
and hollow look," he says. "Once you have it, you can identify it in other
people, but it can be cosmetically reversed."
One doctor who specializes in such reversals is Seth Matarasso, associate
clinical professor of dermatology at UCSF. He is mindful to discuss loss of
facial fat as a function of aging as well as disease and treatment. "As an
immuno-compromised person, one does get facial wasting," he says, "But facial
wasting is very common as we age. What we are used to seeing is skin lying on
fat and muscle. When you have facial fat atrophying, you have skin lying on
muscle. This can be very disfiguring, very disheartening for people with HIV."
Matarasso contends that proactive measures to counter lipodystrophy are out
of reach until physicians have a greater understanding of its precise causes.
Until then, he says, those wanting to restore their appearance can use a
variety of cosmetic options, including facelifts, which soften depressions in
the face, and soft-tissue augmentations, using gortex (synthetic fiber) or
silicone implants, collagen injections and recycling one's own body fat.
A new and increasingly popular form of soft-tissue augmentation involves the
harvesting of connective human muscular tissue called fascia, which is then
made into a semi-solid substance called fascian that can be injected into the
skin to plump it up. "It's not for everybody," says Matarasso. "Some patients
have bruising, some have swelling. I simply don't know how long it will last.
Done over a series of times, a patient can build up a reservoir, so there's
more of a 'take.'" And then there's the cost: charges can be as much as $300
to $400 per syringe of fascian and Matarasso sometimes recommends two
syringes per treatment to ensure the desired effect lasts longer.
While Matarasso advises that fascian is no miracle or fountain of youth, he
observes that cosmetic treatments do help patients feel better about their
appearance, even as they feel healthier overall. "We've seen the gay
community wasted by HIV/AIDS and it's a terrible, terrible burden," he says.
"We've come so far and now we are dealing with some of the changes in coping
with the disease. Many men feel great -- their T-cells are up, they're
working out, they're able to go back to work. But they are watching their
faces change before their eyes. It can be a physical stigma."
Both Wendelin and Finan opted for fascian injections performed by Matarasso
and report their pleasure with the results. Cecilia Chung continues with her
treatment interruption, though her somewhat increased viral load since coming
off the meds has led her to consider resuming treatment. She is trying to
postpone taking anti-retroviral drugs for as long as possible, though she is
well aware of their benefits. The dilemma she faces is a common one among
people living with HIV/AIDS and on medications: drug therapy can restore a
large measure of health, but often at the expense of one's appearance and
sense of normalcy. "If not for [the drugs], I don't think I would enjoy the
health that I have now," she says. "before I started taking them, I was
suffering with chronic fatigue syndrome. Since taking them, my health has
gotten better and [I can now] work full time. But all the side effects are
very difficult to deal with."
If the effects of lipodystrophy are hard to cope with, part of the reason is
that appearance and our attachment to the way we look is more than skin-deep.
Just as fat, tissue and muscle lie beneath our faces, layers of emotion --
pride, anxiety, fear -- can be concealed by the image we project to the rest
of the world. If we live long enough, each of us will have to negotiate those
empty spaces below the surface, finding or making fullness in spite of all
that seems hollow, whether we are HIV positive or not.
=====
Letters to the Editor
Bay Area Reporter
June 10, 1999
Why cover ACT UP/SF?
I've been a gay activist since the early 1970s when I moved to San Francisco
at the age of 18. I am concerned about the objectivity of your ongoing
coverage of Michael Petrelis, David Pasquarelli, and ACT UP/SF.
I feel that your obvious hatred of Pat Christen and the San Francisco AIDS
Foundation is influencing your coverage and over-exposure of these dangerous
fringe fanatics. Regardless of your opinion of Pat Christen and the
foundation, must you give legitimacy to these troubled anarchists just
because you share a common hate?
Please think of the health and welfare of the community. By constantly giving
them a forum they are able to perpetuate their ignorant misinformation. For
example:
-- That HIV doesn't cause AIDS;
-- PWAs should stop taking their medication;
-- Barebacking is good;
-- Safe sex is tyrannical.
Most of the gay men I know think these ideas are ridiculous and dangerous,
why not cover them?
Also the initiative proposed by these jerks to "reopen the bathhouses" is a
cynical publicity stunt to gain more recognition and is also a red herring.
We already have open bathhouses, they are sex clubs with showers which
currently operate. What they want is completely unregulated public
establishments with locked doors. You don't have to be a sociologist to
deduce that with drug use on the rise, coupled with normal human male sexual
behavior, this will lead to more unsafe sex and thus increase STDs, including
AIDS, some of which will be resistant to current therapies. The Health
Department has data to back this up, also it's just common sense. Haven't we
learned anything? This is political suicide. It is a divisive ballot
initiative that will never pass a general election. All that it will do is
make our gay male community look like selfish hedonists, thus giving further
ammunition to the radical religious right.
Randy Wendelin
San Francisco
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ACT UP San Francisco
1884 Market Street * San Francisco, CA 94102
Phone: (415) 864-6686 * Fax: (415) 864-6687 * www.actupsf.com