The official blog of The Project Red Ribbon Care Management Foundation, Inc. (TRR).

  • TRR LOVE FUND

    TRR Love Fund is the arm of the foundation which provides medical assistance to the financially challenged PLHIV.

  • Care assistance for HIV Test

    The Care Assistant Program involves assistance to HIV testing and HIV and AIDS Treatment hubs in the Philippines. Our volunteers schedule the client to the clinic or hub, assist with the procedure in the clinic or hub and conduct peer counseling

  • HOTLINE ASSISTANCE

    With the TRR Hotline Numbers, our volunteers answer concerns and inquiries about HIV and AIDS, do counselling, refers clients to nearest HIV Testing facility, HIV and AIDS Treatment Hub and government and NGO organizations for support

  • PEER COUNSELING

    The foundation volunteers conduct one-on-one counseling either on the phone or in person. They also conduct group counseling

  • SUPPORT GROUP TALK

    The support group talk (SGT) is a program that involves giving HIV lectures by guest speakers, discuss topics about HIV, care, treatment and support, discussion issues related to HIV

  • OUTREACH PROGRAM

    The foundation's outreach program is geared towards providing support to our fellow PLHIV's in the HIV and AIDS Treatment Hubs. Volunteers hand out of donations of medicines and special gifts to PLHIV, give inspirational talks by invited guests to a group of PLHIV, bonding over snacks or meal, visit the sick who are confined in the hospital

  • Referral System

    As part of treatment, the foundation's referral program involves our volunteers referring clients to specialized doctors who are HIV friendly. The foundation has it's own list of specialty doctors of low cost for the indigent PLHIV.

  • Online Support Group

    The foundation has a private Online Support Group in facebook. This group of advocates, supporters, counselors, health Workers and PLHIV

  • Home Health

    Aside from client counselling, the foundation volunteers also do family counselling and home visitation for awareness and continuance of care.

  • Health Fitness

    The foundation believes in holistic approach to treatment and care, thus inclusion of these programs: yoga, dance, swimming, jogging and running, boot camp workouts

  • EVENTS

    As part of awareness and education program, the foundation organizes its own national events to coincide with the international AIDS events: World AIDS Day and International AIDS Candlelight Memorial

Saturday, March 31, 2012

Thank You!


Thanks for the pledges for the month of April. Fellow pozzies have pledged to donate for next month for The Love Fund. Their total donation already reached P10,000.

It is nice to know that people are helping out. One poz donated from his monthly allowance. Another donated by not going to 2 restaurant dinners for next April. One poz sacrificed his 3 movie dates for next month just to contribute. Instead of going out on 1 Saturday night, a poz opted to donate his budgetted allowance to The Fund.

I am so proud of these poz' who are really willing to help out to our fellow poz who are in need. Any amount of contribution is good enough. One even contributed P50 but really that will go a long long way. A friend just texted me that she is selling chicharon and the profit will go to The Love Fund. I'm so happy.

Thank you to all who are pledging and who are already contributing to The Love Fund. People are still waiting to be helped and with your continuous support, I know we can reach out to them.

I'm also calling out to my other fellow poz. Please help out. Most of us have been there. We experienced the financial difficulty. If you can sacrifice a little and help a little, you too can help.




*** Please donate to the LOVE FUND. It is for the benefit of the indigent pozzies that are in dire need of financial help especially for their initial lab tests and OI medications. This is a project of Dr. Rossana A. Ditangco.

If you want to donate:

1. Deposit your cash donations to:

                BDO Savings Account Number: 1420060188
                Account Name:  Rossana A. Ditangco

2. Personal cash donations to RITM-ARG and look for Ellen Domingo or Maram Bartolome 

Please email me at pozziepinoy@yahoo.com. I will give you the details of the LOVE FUND. Monthly updates on the beneficiaries of the LOVE FUND will be posted in my blog.

Thank you so much!


Credits:

www.freedigitalphotos.net



FOR TOPIC SUGGESTIONS, please email me at pozziepinoy@yahoo.com
DONATE to The Love FundThe Love Fund

Friday, March 30, 2012

Love Fund: March 2012 Report


So here is an update of the Love Fund beneficiaries. Aside from the ones that I mentioned before, 2 other beneficiaries of the Fund have been provided with support. One patient had breast cancer and the Fund was able to support the patient with meds, lab exams for mastectomy. Courtesy of PCSO, Dr. Ditangco and I have arranged for full financial support for her chemotherapy and hospitalization.

Another patient with pulmonary tuberculosis has been helped by providing him with the medicines that he needed. Ms. Maram said that the patient was so grateful that somehow, people who he don’t know at all was willing to share part of themselves with him.

This is my monthly report about the Love Fund beneficiaries. To another donor who just recently donated P500.00, this would definitely go a long long way. Thank you. If only all of us can at least donate P100 per month to the love fund, I am pretty sure that patients who are in need of financial support when it comes to medicines, hospitalizations and lab workouts would surely appreciate the help.










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DONATE to The Love FundThe Love Fund

Thursday, March 29, 2012

PP Prayer's List 4


I will be sending the PozziePinoy's Prayer list again to the heads of churches here in the country and in two church organizations in the United States this Friday evening. Three new pozzies have been added to this list.

Please email me fast or just ask for a name inclusion in the comment box if you want your name or your friend's name to be included here.

In need of prayers: to watch over their health, to help them keep a positive outlook in life despite HIV, to help them face all health fears, to guard them against possible infections.

1. Poz Angel
2. PositHive
3. PozzieBoy23
4. GeekPozzie
5. Ryan HIV
6. Iamhivpositive
7. PozJerry
8. Casually
9. Bohemian
10. Chris HIV
11. Mike HIV
12. Kien HIV
13. Mark HIV
14. Panga HIV
15. Rob HIV
16. Albert HIV
17. Turvey HIV
18. Mao Hiv
19. Jersey
20. Jayjay HIV
21. 2ndLease
21. FB guy
22. Kiev
23. Spongie
24. iampositive25
25. Paranoid Freak
26. Marky
27. Sam HIV
28. Carlo HIV
29. Rob 2WL
30. Tipsyheaven1
31. Aqua HIV
32. SG HIV
33. RenalCB HIV




FOR TOPIC SUGGESTIONS, please email me at pozziepinoy@yahoo.com
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Home Service Vaccinations


Ate Ellen Domingo is a dear friend of mine ever since I moved to RITM-ARG. She is one of the nurses there. She told me that she helped Dr. Ditangco in organizing ARG from the very start so she knows every detail about the clinic. She has been in contact with a lot of poz and has become one of the counsellors there.

I communicate with her if I have health problems and if other pozzies have problems. I also communicate with her if I need to schedule for my CD4 test and if I have questions about the availability of the ARV's. Lately, we have been talking about the Love Fund and her and Ms. Maram, another nurse in ARG have been emailing me about it.

Aside from her duties as a nurse in RITM-ARG she also does vaccinations outside the clinic. She has been invited by different organizations to do their vaccinations for their employees. In the case of persons with HIV/AID, she knows what to give them. In my case, she even went to my place to give me my 2nd hepa B shot and meningococcal shot. She gave me a booklet for my vaccination record too. She told me that other pozzies have also asked her to do home service for their own vaccinations, some she met in their homes, some even in their offices and others in the malls.

In case you want a vaccination home service, here is a list of what vaccinations she can give you together with the actual prices. She lives in Alabang, but she go to any place in Metro Manila. For her services and transportation, it is a case to case basis. Just talk to her about it.

1. Hepa B -P650
2. Hepa A and B (twinrix) -P2,700
3. Meningococcal - P2,800
4. Varicella - P2,550
5. Pneumococcal - P1,100
6. Influenza (Flu) - P600
7. HPV - P3500/shot x 3 = P10,500 (complete vaccination)

You can text Ate Ellen at 0916-826-1831. Just don't text her for scheduling for lab tests or consultations in RITM or other questions in ARG (like patient traffic, etc) as she is not the person to text with regards to that.

Remember, before taking any vaccinations, you should ask your doctor first. Vaccination is very important to all of us who are immunocompromised but still the doctor will tell us which vaccinations will really work for us!




© Copyright. All Rights Reserved by Pozziepinoy 2012





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Tuesday, March 27, 2012

Award Winning Video

This video by students of the Ateneo School of Medicine and Public Health was named Best Video Presentation by the Scientific Committee of the 2012 UP Manila-National Institutes of Health Research Forum.

Most of the people who have been interviewed here are people from RITM-ARG. If you would go to my hub, you will see them there. My previous ID doctor, Dr. T was also interviewed here. Dr. Ditangco was also mentioned.


I hope you will learn something from this video.




*** Please donate to the LOVE FUND. It is for the benefit of the indigent pozzies that are in dire need of financial help especially for their initial lab tests and OI medications. This is a project of Dr. Rossana A. Ditangco.

If you want to donate:

1. Deposit your cash donations to:

                BDO Savings Account Number: 1420060188
                Account Name:  Rossana A. Ditangco

2. Personal cash donations to RITM-ARG and look for Ellen Domingo or Maram Bartolome 
Please email me at pozziepinoy@yahoo.com. I will give you the details of the LOVE FUND. Monthly updates on the beneficiaries of the LOVE FUND will be posted in my blog.



Thank you so much!

New Cases in February 2012



The DOH-NEC HIV/AIDS Registry for February 2012 is out. It said that in February 2012, there were 274 new HIV cases, which is 72% higher compared to the same period last year and the highest number of cases ever reported in the registry.

Facts:
  1. 98% of the cases were males
  2. Median age was 28 years
  3. 46% came from the National Capital Region (NCR)
  4. Mode of transmission were sexual contact and needle sharing
  5. Males having sex with other males were the predominant type of sexual transmission (87%).
  6. Most (98%) of the cases were still asymptomatic at the time of reporting.
  7. Of the 272 HIV positive cases, 6 were reported as AIDS cases, all were males
  8. 9% of the reported cases were OFW’s
  9. Of the AIDS cases, there was one reported death for the month, a 41 y.o. male.
For details check this link:


Newly Diagnosed HIV Cases in the Philippines



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Day 175


Today is my 175th day of taking my ARV's. Like before, I still have 100% adherence, no missed or late intakes. For those who haven't read my entire blog, I am currently taking tenofovir, lamivudine and efavirenz. No side effects anymore, well, I guess my body has adjusted to them already. I am still taking them all at 10pm. I am still taking my cotrimoxazole daily and my azithromycin once a week.

Up to now, I am down with a cold. But somehow it is going away. No more sneezing, less coughs and I can breathe better now. Thanks to the fluid therapy I'm doing. Like in my previous entries, this is the first time that I have been sick for almost 8 months now. Health is my priority so I need to get well first before going back to work.

I am still counting guys. These days are very important to me because these are the days that I can say I am alive. They are my strength. They are my blessings. 175 in all, full of experience, full of love, full of courage, full of hope, full of positivity.




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Email 8: Clueless

“Hi Pozziepinoy!

I hope your are doing well. First I would like to thank you for putting up you blog, it is really very insightful. 

I am XXX years old currently in XXX. I’ve been here since XXX. I had myself tested and this morning I was told that I am HIV positive. I'm currently at a loss right now and clueless as to what my next step would be. 

I haven't told anyone yet but eventually I have to tell my close friends and my family. I definitely would have to go back to the Philippines very soon. 

I hope we could meet up or talk somewhere. It scares me a lot. 

I don't know if I could still find a job back home, or if my health would hold back, or if financially I could support this fight. I don't want to be a burden to my family or to anyone.

I would like to take this opportunity to ask for your help and advice. I really really need it right now.... Thank you very much!!!

Sincerely,

XXX”


Hi XXX,

First of all, thank you for reading my blog. It is good to know that I am able to reach out to other people. It is now one of my missions in life.

It really is heart breaking when you find out that you are positive. You said it's bad. I agree with you, but looking from a different perspective, for me it is also a blessing that you found out early before you are already sick brought about by the weakness of your immune system. Unlike me who was already bedridden because of pneumonia before I got myself tested, I believe that you are still in good health when you found out. You are still a lucky guy XXX, because you have a great chance to make your immune system to recover fast unlike some of us who have to wait for years for ours to get back to normal levels.
I know now you are confused but I'll try to answer your doubts one by one here.

Regarding jobs, there is no mandatory HIV testing needed for employment here. It is against the Philippine law. It is still voluntary testing. In that case, you can definitely find a job here for you. Your credentials are more important here. There are also other countries that don't require an HIV test prior to employment. So don’t worry too much.

About your health, I can guide you step by step on the procedures on what you need to do. The priority tests that you need to do are the CD4 test and the viral load test. They maybe expensive in XXX but here in the Philippines, the CD4 count costs around P2,500- P3,500 while the VL costs around P5,000-P7,000. The CD4 count determines your immune system strength while the VL determines the amount of virus you have. The CD4 test is done every 6 months while the VL is done once a year. The CD4 test also will determine if you need to take the ARV's (antiretroviral's). Planing your finances is the best you can do for now.

Financially, most of the burden come from the initial lab workout to be done. It will cost you around P5,000 for everything if you are not sick now. However, if you are experiencing illnesses at present, your doctor will tell you to do more tests which will cost you more. I spent like half a million pesos because of my confinement in the hospital, including all the medicines and all the lab workout, because I was already sick before I found out that I was positive. So learn not to be like me. In your case, don't get sick! Be proactive in having your health status now. The sooner you know your health status the better the chance for you not to spend a lot. Don't you worry too. The HIV/AIDS hubs here are free --- free consultation from doctors and free ARV's.

Tell your family and close friends about your health status when you are ready. It is good to talk and know that people you love support you. When I found out that I was positive, the following day, I told my friends and family about it. I was confident that they would understand and they did. I promised them that I will fight to survive it. I know that you can do it too.

I hope I was able to answer everything. Please email me again if you have other questions. I can meet you when you come back to the country.

I will add you to my PP Prayer's List which I give to different church organizations in the country.

Just stay positive XXX. I will be here for you.

Pozziepinoy





***************



A few days later:






Hi Pozziepinoy!

How are you doing? I hope everything is well. 
By the way I have already told my sisters about my condition. It was really hard telling them at first. I haven’t cried that much ever in my life. But you are right, they are here to support me and love me. They told me that together as a family we can fight and overcome this... They are coming to XXXX to pick me up and help pack my things. :)

We haven’t told my parents yet. We are going to do it together once we’re back in the Philippines on XXX. I hope everything will be alright...

My close friends are very supportive too. There wasn’t any point that they judged me or questioned my identity when I told them. One of them even said that whatever happened in the past is not important. What's more important is for me to get back on my feet and be as healthy as possible. They were actually sadder not because I have this disease, but because I'll be leaving them soon. :)
I feel so blessed to have such family and friends. I know my parents would be there for me too. I'm really praying for that. 

Well, I guess I want to thank you too. Your words and advice really are helpful. I hope I can be this helpful to others, as well. Thanks a lot bro, for the support and prayers! 
Sincerely, 
XXX







Hello XXX,

I am so happy that everything went well. It is so heartwarming when one feels the love and support of family and friends. I salute you for being courageous. Like what I said before, your family and friends will be there for you and now you know that.

You are not alone. People you love will be with you to fight your disease. Your obligation and responsibility now is to fight it for yourself and for them.

Starting now, smile and be healthy.

I will be here for you. Email me your other concerns when you get back home. I will also give you my cell number so we can correspond.


Pozziepinoy





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Monday, March 26, 2012

Answered Prayers

“I have had sleepless nights the months because of neuropathy, last night i was able to sleep better. I am so happy i woke up at 6 am. The Lord indeed answers prayers. Thank you Lord. Thank you too Pozziepinoy for the prayer and for including me in the prayer request. Hope This is the start of a healthier me. Thank you Everyone. Hope everyone gets better too. Thank you Lord!” --- XXX

“Maraming salamat sa pagsama mo sa pangalan ko sa Prayer’s List mo. Malaking bagay ito lalung-lalo na sa aking naguguluhan dahail sa sakit ko. Nalaman kong may HIV ako nung January lang at naging mababa ang CD4 ko. Matagal akong nababahala pero dahil sa mga prayers mo at ng mga taong di ko kilala, naramdaman ko na gagaling ako. Ngayon alam kong may mga taong nagmamahal sa akin. Maraming Salamat. Nakatulong ito ng malaki sa positibong pagharap ko sa sitwasyong kinahaharap ko ngayon.” --- XXX

“Thank you so much for adding me to your list. You just don’t know how it has helped me emotionally that somebody is praying for me and for all of us. To you Pozziepinoy, God bless you!” --- XXX





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Refill


Tag and I just came back from RITM-ARG for my refill. It only took us 30 minutes to get there by car from our place. I was supposed to get my CD4 and my CBC test today but because of my cold, I didn’t. I know it would affect my CD4 result. Instead I scheduled it again for next month.

Prior to going there, I already texted Ate Ellen if they can give me my 3 month supply today and she answered yes. When I came over, Ate Ellen was there and she assisted me totally. She had me sign four PhilHealth forms. I gave her photocopies of my PhilHealth payment and she was glad that I already paid until December 2013 since the PhilHealth contributions for individual paying members will increase by 100% by July of this year. My CD4, she then said will be free when I come back next month. 

Dr. Ditangco was there too and after saying hi, we chatted for a while. We talked about the Love Fund and how they have used the funds for their patients. I also told her that I have connections with PCSO and we will coordinate with one of her patients who have cancer. I gave her the requirements that her patient will need to bring to the PCSO office. I told her that I am so happy to be of help.

I talked to Ate Ellen again and said that they will formally launch the Love Fund next moth. She said that there are already a few donors and I promised her to contribute more next time. I told her that I have been advertising it in my blog to get donations. She then asked for my email address because Ms. Maram, will email me the beneficiaries of the Love Fund. I am so excited.

RITM-ARG was so organized. They know me by my first name there. As soon as I got the booklet, I went straight to the pharmacy to get my 3 month supply of ARV’s. In less that 5 minutes, I was already carrying my bag of “vitamins”. 

After saying goodbye to the staff and Dr. Ditangco, Tag and I headed straight home. Now, I am resting for the day to get control over this cold.




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Sunday, March 25, 2012

First Time


I got a cold. This started yesterday and I felt it brewing. First time in almost 8 months! I once told by Dr. Ditangco that if ever I’m going to be sick it will not be caused by my virus anymore since I already passed my 6th month of taking ARV’s. I believe her.

I am fully loaded with vaccinations 3 months ago so I believe I am safe. This is a normal common cold that affects everybody. But I won’t let my guard down still. I am on ARV’s but I am still immunocompromised. 


I’m still having a positive attitude about it. This too shall pass I know. I surpassed a lot of trials and one bout of cold can’t pull me down. But of course, I will take it seriously. I have the capability to fight this malady. I’ll drown it with vitamin C and lots of fluids, like how everybody does it. 

I guess I have to postpone my CD4 test tomorrow then because my illness now will compromise the result. I’ll send a text message to Dr. Ditangco later if I can do it next month, once I am fully recovered. Hopefully she would agree. But I still have to go to RITM-ARG for my refill of ARV’s. I only have one week of pills left so tomorrow is still a priority. I need to go there too to get an update on the Love Fund. As promised I need to update my donors on the patients that have been helped by it.

For now, I have to focus first on my cold. What I need now is to get better fast so my body’s defenses can recover once more.







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Saturday, March 24, 2012

Mentally Preparing For ART

I know you are scared. I know you finished all your lab tests including your CD4 count test. Your doctor told you that you are about to start with your ARV Therapy (ART). You are very anxious.

Here are some tips.

1. Read about ARV's. Knowledge is power. It is best that you are mentally prepared for everything.
    a. Know the different cocktails and combinations.
    b. Know the side effects
    c. Know the time to best take them
    d. Visualize your medicines. Check their sizes and forms

2. Know the importance of adherence. 
    a. Read about adherence.
    b. Practice with your vitamins. Think of them as your ARV's. Practice taking them at the same time of the day.
    c. Give importance to consistency and habit formation.
    d. Be serious about adherence. Tell yourself you can't miss a dose or you can't be late in taking them.

3. Get ready with your gadgets
   a. Set up your timer in your phone, in your watch, or any alarm system in the house.
   b. Set aside a place for your bottles of ARV's. Usually it should be a dark, cool storage place.
   c. Buy 2 pill boxes. One, for your daily doses from Monday to Sunday. The other one is a pocket box for your travels or when you need to stay late at night somewhere.

4. Track with a notebook
   a. Track your daily intake of meds
   b. Write the signs and symptoms of the side effects or even good reactions of ARV's.
   c. Track also the dates when you will be needing to go back to the hubs for refills.
   d. Tracking is also a good way for you when you are reporting to your doctor during consultations.

5. Start believing in the ARV's
   a. Positivity helps a lot.
   b. Give the ARV's power to help you and your health.
   c. Start believing that whenever you will take your ARV's, they will work miracles on you.

6. Be honest with your doctor
   a. Report all signs and symptoms to your doctor as soon as they come out.
   b. Be ready to go to the hub whenever possible if there are ARV side effects.
   c. Follow what your doctor tells you to do. Learn how to trust him or her.

I know you can do it. I surely did all of these and it really worked. Up to know, I am still 100% adherent to ARV's. No missed or late intakes.

Be prepared now then everything will be smooth sailing once you are holding your first pills in your hands.


 

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PP List Sent!


I already sent my PP Prayer's list to heads of different religious organizations for this week. I will be doing this every week for all of us. It is another way for me to help other people and as a way to give thanks for all my blessings especially my good health now.

The heads of religious organizations just requested me to send them letters of answered prayers so for every one in the list let me know if you have answered prayers every week. Look for small miracles every week and then let me know.

You can have your fellow poz' names to be part of the list too. Just send them to the comment box or just email me. Everybody's names are in coded.

Always remember that YOU are not alone in your journey. There are others who are rooting for you now, so keep the faith and have courage in your heart. Be healthy all the time!





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Assisting Aqua!


I am assisting a new poz. His name is Aqua. He has the same condition as I had 7 months ago. He had bouts of pneumonia and his CD4 is below 100 too. He just finished all his lab workout and I am glad that everything is good..well, same as mine before.

I encouraged him to fight back. He will soon be on ARV’s and he is pretty scared about the side effects, especially the rashes. I told him that everything will be fine. He is from San Lazaro Hub and he said he is hearing good things about RITM-ARG. I told him that all hubs are the same and what is important is to believe and trust his doctor, whom he said is so good and patient to him. I told him to just stick to his hub then.

I am a busy person but my mission continues. I know what responsibility this disease has given to me and I am really taking it seriously. I am here to help by continuously counseling and assisting people for financial support. 

I am flattered when a fellow poz texted me and said “on behalf of everyone you are helping, thank you for doing what you’re doing.”

To you Aqua, who I know is now reading my blog, soon you will be strong again. Keep the faith, believe in your doctor and later believe in your ARV’s. Like most of us who followed these simple rules, 100% you’ll be alright!






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Friday, March 23, 2012

Heaven's Gate

I guess when you start helping, people notice it and they start giving. This month of March, I was fortunate to have helped by patching up 2 poz with donors. One poz came from SAGIP and one from San Lazaro. They were assisted financially with their initial lab tests and CD4. I am so happy.

One poz before asked me if the Love Fund can assist with other pozzies from the other hubs. I told him that for now, it is for RITM-ARG patients. But now, with some donors emailing me and some donor friends who I can approach to for help, we can assist some other pozzies from the other hubs.

Sometimes, when we feel burdened by just the fact that we have HIV, the heaven's gate will open. Now I believe that in this case, HIV can bring the goodness from people.








Credits and References:



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Thursday, March 22, 2012

PP Prayer List 3


Keep on emailing me for prayer requests. Will send this The Pozzie Pinoy’s Prayer’s List every weekend to different religious groups. 

Today I am adding 5 more poz for prayers. For those who are already in the list, please pray for all of us and for all our families and loved ones. We are all in this together!

1. Poz Angel
2. PositHive
3. PozzieBoy23
4. ExofPB23
5. Ryan HIV
6. Iamhivpositive
7. Poz jerry
8. Casually
9. Bohemian
10. Chris HIV
11. Mike HIV
12. Kien HIV
13. Mark HIV
14. Panga HIV
15. Rob HIV
16. Albert HIV
17. Turvey HIV
18. Mao Hiv
19. Jersey
20. Jayjay HIV
21. 2ndLease
21. FB guy
22. Kiev
23. Spongie
24. iampositive25
25. Paranoid Freak
26. Marky
27. Sam HIV
28. Carlo HIV
29. Rob 2WL
30. Tipsyheaven1




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Immuno Depression

I am always discussing about how to improve the immune system, that is increasing the CD4 count. This time, I want to discuss in detail some causes on how the immune system can be compromised. The studies that will be presented are from individuals who don’t have HIV. So for us immuno compromised, we should all pay attention and read on.

1) Low CD4 counts in the intensive care unit

This means that severe cases of infections can cause a decrease in CD4 counts.

2) Low CD4 counts in Various Human Infections

    a) Pneumonia, pyelonephritis, abscesses, infected wounds, cellulitis, and sepsis
    b) Low CD4 counts in malaria
    c) Low CD4 counts in mononucleosis

Mononucleosis, commonly called 'mono', is a common viral illness, especially in young people of college age, and can last for several months. It is caused by cytomegalovirus (CMV) or Epstein-Barr virus (EBV), and usually results in prolongued cold and flu symptoms, swollen lymph nodes, and fatigue. 

   d) Low CD4 counts in sepsis
   e) Low CD4 counts in pulmonary tuberculosis

Tuberculosis is a relatively common infection in people diagnosed HIV-positive, especially when compared to the general population. It is also relatively common in other people who are immunosuppressed, such as alcoholics, the homeless, intravenous drug users (IVDUs), and people who suffer from malnutrition.

   f) Nearly all viruses interfere with lymphocyte function

The viruses that infect human lymphocytes, are: Hapatitis B virus, Group C adenoviruses, Herpes simplex viruses, Cytomegalovirus, measles, mumps, respiratory syncytial virus (RSV), Vesicular stomatitis virus, Inflenza A, Parainfluenza, Rubella, Poliovirus, Lymphocytic choriomeningitis virus, and Human T-cell leukemia viruses I and II. This also includes HIV and other retroviruses.
3) Low CD4 counts caused by injections of foreign proteins

    a) CD4 irregularities in hemophilia

Hemphiliacs were one of the original HIV risk groups. As mentioned above, hemophiliacs who are HIV-negative have been found to have lowered CD4 counts as well as lowered CD4/CD8 ratios, and it appears that this effect is caused by injections of factor VIII.

    b) CD4 irregularities caused by injected drugs   
    c) CD4 Irregularities caused by in utero exposure to opiates

4)Low CD4 counts caused by injuries and burns
5)Low CD4 counts in normal human pregnancy
6) Reduced CD4 counts from overexercising
7) Low CD4 counts in malnutrition
8) Daily variation of CD4 counts
9) Changes in CD4 counts and lymphocyte function due to psychological stress and social isolation

Now we know that these are some of the causes for the immune system depression, even in normal individuals, then we, the immunocompromised ones should pay attention to them now.




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Pointing Fingers

A friend sent me a link about a blog revealing some guys who "may be" HIV positives who "may" have been spreading the virus around out of revenge or hatred. This is no news anymore to me as I've heard it decades ago. In the blog, it even posted profile pictures of chatters in Planet Romeo who they "suspect" to be positives.

My friend is pretty worried. I calmed her down by telling her that there are things that we can't control. However, there are still things we CAN control, that is, having safe and protected sex all the time. We can't allow the virus to spread anymore because of ignorance. We know all the facts that it is spreading like wild fire here in country so why allow it.

The world really is a scary place. But we don't have to be scared if we know what we are dealing about. We have been educated on the transmission of HIV so we know then how we can protect ourselves, even from people who are seemingly dangerous around us. We have to focus on us, instead of pointing fingers. We know our responsibility to ourselves and to society. We have to live our lives in the best possible and healthy way.

So the best advice is still to have a monogamous relationship to a person that you very well know. In case you don't practice that, then best is always have safe and protected sex.




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Wednesday, March 21, 2012

HIV and Splenomegaly

Help me pray for a poz who I just recently been encouraging to fight to be healthy again. He was recently been diagnosed. He’s on ARV’s now and his doctor told him that he/she will replace his ARV’s because they are not working. Yesterday, he had his check up and they found out that he has splenomegaly or enlarged spleen. 


So for all the poz here who are reading always reading my entries, help me pray for him so that he will recover fast from this and whatever new cocktail of ARV’s his/her doctor will give, let’s pray that they will work for him.

So what is splenomegaly?

The spleen is an organ located in the upper left quadrant of the abdomen just below the diaphragm and protected under the lower left ribs.

The spleen has a couple of important functions involving blood cells within the body.
  1. It filters blood and removes old and damaged red blood cells, bacteria, and other particles as they pass through the maze of blood vessels within the spleen.
  2. It produces lymphocytes, a type of white blood cell that produces antibodies and assists immune system.
The filtration system is part of the red pulp while the white pulp of the spleen contains the immune functioning cells. Normally, the spleen is a small organ about the size of a small fist or orange. Splenomegaly describes the situation where the spleen enlarges in size (spleen+megaly=enlargement).

What are the causes of an enlarged spleen?

The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded with abnormal cells or deposits.

1. Abnormal red blood cells: Since the spleen filters abnormal blood cells and removes them from the circulatory system, diseases that result in abnormal red cells will cause the spleen to enlarge.Sickle cell disease, thalassemia, and spherocytosis are examples of diseases that form unusually shaped cells that cannot easily maneuver through the small blood vessels and capillaries of the body. If they are not removed by the spleen, these abnormal cells can cause blood clots and decrease circulation. However, removing them causes the spleen to swell and enlarge.

2. Viral and bacterial infection: The spleen is involved in making cells that fight infection and part of that response is to enlarge. This is commonly seen in viral infections such as infectious mononucleosis (caused by the Epstein Barr virus), AIDS and viral hepatitis. Examples of bacterial infections associated with splenomegaly include tuberculosis, malaria, and anaplasmosis (formerly known as ehrlichiosis).
Splenic vein pressure/blockage: Blood enters the spleen through the splenic artery and leaves through the splenic vein. If the pressure within the vein increases or if the splenic vein becomes blocked, blood cannot leave the spleen and it may swell. Because of the relationship to liver blood flow, cirrhosis and portal vein obstruction can cause complications with venous blood flow from the spleen. Congestive heart failure may cause both the liver and spleen to swell because of increased venous pressure.

3. Cancers: Leukemias and both Hodgkins and non-Hodgkin lymphomas can cause the spleen to enlarge, as can a variety of other tumors including melanoma.

4. Metabolic disease: Metabolic diseases that enlarge the spleen include Niemann-Pick disease, Gaucher’s disease, and Hurler Syndrome.

What are the symptoms of an enlarged spleen?
An enlarged spleen itself usually causes no symptoms; the symptoms of an underlying disease are often the reason a patient might seek care. These may include weakness and fatigue from anemia, easy bleeding from decreased platelets in the bloodstream, or recurrent infections from poor white blood cell function.
However, as the spleen enlarges, it can press up against the diaphragm, the muscle that separates the chest and abdominal spaces. Diaphragm irritation may refer pain to the left shoulder. An enlarged spleen also can push toward the stomach and cause anorexia or a loss of appetite and a sense of early fullness when eating.
Since the enlarged spleen grows beyond the protection of the ribcage it becomes more likely to be injured, thereby increasing the chance that abdominal pain may occur.

Depending upon the amount of spleen damage after injury, there can be bleeding into the abdomen with associated distention (bloating), pain to the back and shoulder, and signs and symptoms of shock. These can include weakness, shortness of breath, and cool, clammy and sweaty skin.

When should I seek medical care for an enlarged spleen?

Most often, the diagnosis of an enlarged spleen is made incidentally by the care provider. There are usually no symptoms that would bring a patient to see a doctor. However, unexplained symptoms like those mentioned above should be investigated by a care provider.

How is an enlarged spleen diagnosed?
Most often an enlarged spleen is found incidentally on physical examination by the health care practitioner. The spleen usually is small enough to hide underneath the left rib cage in the upper abdomen. The enlarged spleen tip can be felt in the left upper quadrant of the abdomen and as it continues to enlarge the tip moves towards the right lower quadrant. In some thin people, the spleen can be felt in the abdomen but is normal in size. An enlarged spleen measures about 12 to 20 cm (4.5 to 8 inches) in any dimension while a spleen greater than 20 cm (8 inches) is considered severe enlargement.

If there is concern that the spleen is enlarged, blood tests may be considered to assess the cause of the enlargement. Common tests may include a complete blood count (CBC) looking for abnormal red or white blood cells, a peripheral smear to assess at the types and shapes of blood cells or a monospot, if the diagnosis of infectious mononucleosis is being considered. Other tests evaluating liver or heart function may be considered if clinically indicated.

An abdominal ultrasound, CT, or MRI of the abdomen may be used to evaluate the size of the spleen and to look for other abnormalities in the abdominal cavity that may be associated with splenomegaly.

What is the treatment for an enlarged spleen?

Treatment for an enlarged spleen is usually directed at the underlying medical condition that resulted in the splenomegaly. Depending on the underlying problem, treatments can be with antibiotics, chemotherapy, or radiation. These treatments are for the underlying disease and may allow the spleen to reduce in size; however, in some cases, the spleen will remain enlarged.

On occasion, the spleen may need to be removed surgically (splenectomy = spleen + ectomy=removal) as part of the disease treatment. For example, in hereditary spherocytosis, removing the spleen prevents the anemia that occurs when the abnormally shaped red blood cells are continually being filtered out and removed from the blood stream.

What are the complications of an enlarged spleen?

When the spleen enlarges, it loses some of the protective covering of the lower rib cage and becomes more vulnerable to injury. The enlarged spleen is fragile and can be damaged with relatively minor blows to the upper abdomen. It is a relatively solid organ and can fracture or crack causing significant and potentially life-threatening bleeding.

The enlarged spleen can also trap an excessive number of blood cells within it causing:
  • anemia (decreased numbers of red blood cells), which may lead to weakness, shortness of breath, and easy fatigue;
  • leukopenia (decreased white blood cells), which may lead to increased risk of infection; and
  • thrombocytopenia (decreased platelets), which may lead to infection or to bleeding problems.
If the spleen needs to be removed, there is an increased risk of infection, especially due to bacteria such as pneumococcus (Streptococcus pneumoniae), Hemophilus influenza, and meningococcus (Neisseria meningitides). It is important to consider keeping immunizations (particularly the pneumococcal vaccine, since about 50% to 90% of post splenectomy infections are due to encapsulated streptococci) current against these infections in patients whose spleen has been removed.

Can an enlarged spleen be prevented?

Splenomegaly is a complication of an underlying disease or illness and in itself cannot be prevented. Ideally, early recognition of an enlarged spleen may help the health care practitioner come to an early diagnosis as to the cause and perhaps prevent further spleen enlargement.

What is the outlook (prognosis) for an enlarged spleen?

Depending upon the cause, the enlarged spleen may return to normal size and function when the underlying disease is treated or resolved.
  • Commonly, in infectious mononucleosis, the spleen returns to normal as the infection gets better. 
  • In some circumstances, removing the spleen is part of the treatment and can make the person much more susceptible to infections. 
  • Many illnesses and diseases result with the enlarged spleen as a permanent physical finding and may result in only a fair prognosis because the person may be more prone to splenic injury, infections, and abnormal bleeding.
Enlarged Spleen At A Glance
  • The spleen is responsible for filtering the blood and removing aged and damaged cells. It is also a key part of the immune and lymph system of the body. 
  • An enlarged spleen is not normal and usually is a physical finding of an underlying disease or illness. 
  • Blood tests may be used to help make the diagnosis of underlying diseases that are associated with splenomegaly. 
  • Ultrasound, CT, and MRI can help measure the size of the spleen and also look for associated abnormalities in the abdominal cavity. 
  • The treatment for an enlarged spleen is directed to the underlying illness. Splenectomy (removal of the spleen) may be part of that treatment.
    So let us help him by praying that he be strong with his fight to be healthy again! To the new poz, I know you will beat this and soon you will be healthy again!



    Credits:
    http://emedicine.medscape.com/article/206208-overview
    http://edition.cnn.com/HEALTH/library/enlarged-spleen/DS00871.html
    www.ucsfhealth.org/conditions/hiv/signs_and_symptoms.html





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    Tuesday, March 20, 2012

    Above 350?


    The cut off here in the Philippines for the issuance of free ARV’s is a CD4 count of 350 and below. That means if your count is higher than 350 then you don’t need to take the free ARV’s yet. Well that is the case only in the Philippines and I think in most developing countries.

    In the first world countries, even if one’s CD4 count is higher that 350, the doctors would already prescribe ARV’s. Of course, the poz will pay for the high cost and usually their insurance will cover for them. The reason for this is that there is a greater probability that the CD4 count will drop below 350 in a matter of months or years so in other countries, why wait? Taking ARV’s as soon as possible especially when the CD4 count is still high will make it possible for a faster recovery of the immune system unlike if the CD4 count falls below 200, which make take years for the immune system to recover. However, since the medicines are so expensive, the hubs would only give free medicines once the CD4 falls below 350.
    So what can you do to improve your immune system, that is, your CD4 count when it is above 350?

    Well it is as simple as this: Stay Healthy!

    Once you have HIV, your immune system will slowly get weaker and weaker without the ARV’s. You will be prone to all kinds of infections that affect non-HIV individuals. You will also be prone to opportunistic infections that non-HIV individuals don’t get. So what do you do? Then be proactive in protecting yourself.

    Here are some tips:

    1. Have regular doctor visits. Getting into care means choosing the right doctor. You should have an Infectious Disease doctor who would serve as your attending physician. He or she will dictate on the status of your health. He or she will decide who to consult with when you have infections. Be honest with your doctor especially when you fee something’s brewing in your body. It is better to report symptoms fast so your doctor can prevent it.

    2. Get your vaccinations. Vaccines are given to stimulate the body's immune response in order to produce antibodies that will protect against certain illnesses. Ask your ID doctor on what vaccinations you need to take.

    3. Eat right to Stay Healthy. While your doctor can help you stay healthy, you have to take some responsibility as well. The first step is eating right. Eat a balanced diet of meat and fibers. The only thing that is not allowed for people living with HIV/AIDS is raw food so make sure that everything is well cooked. Supplementation with vitamins can also help.    VCO and selenium, can be of help but Dr. Ditangco said that still, there are no proven facts to support them.

    4. Learn All You Can Learn About HIV. Knowledge is power. Knowing your illness will help you take charge of your life instead of letting HIV control you. Read blogs of local people. If you need an HIV counsellor to answer all your questions, find one.

    5. Sleep 8 hours a day. Don’t overwork. You are immunocompromised so you need to let your body rest.

    6. Avoid alcohol, cigarette smoking and other vices. You need to stay healthy from now on.
    7. Protection is still the key. If abstinence to sex is not possible, always wear protection when having intercourse. Don’t infect other people anymore. The virus has to stop with you. Unprotected sex might also complicate your situation as another strain of virus might be passed onto you.

    8. Know your Own Body. Knowing your body allows you to keep tabs on your health. Learn to recognize problems before they get serious with this guide to signs, symptoms and solutions.


    So be healthy. That is the only key to a successful recover of your immune system especially if you are still above 350.







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    Medicines Are Free

    I know you are confused. I know you are scared. I know you feel like it's the end of the world. I know you feel paranoid of what others might think of you. I know you blame yourself for what happened to you.

    But it's ok to feel that way. It's normal for anybody to do it. I've been there. The struggle was so great that I felt like there was no hope at all. But there was. There is!

    HIV is not a death sentence anymore. It is like another disease that you have to treat with maintenance medications for the rest of your life. It's like having diabetes or heart disease. As long as you take your medicines every day, you will be alright. It is as simple as that. What's good about our illness is that the medicines are free with the support of the Global Fund and by next year, they will still be free care of PhilHealth. Just pay your monthly donations and after 6 months of taking ARV's in your hub, even your lab workout is free courtesy of PhilHealth. So when it comes to medicines, you have nothing to worry about.

    It is hard at the beginning but as soon as you are already taking your medicines, everything would be smooth sailing. Of course, you still have to do your part in taking care of your body by eating right, exercising and preventing illnesses.

    The medicines are free from the main HIV/AIDS hubs. Even the consultation with an Infectious Disease doctor is free. One has to succumb the cost of the initial lab workout and the CD4 as they are the requirements prior to the issuance of the ARV's. That's it. Once you are qualified for the ARV's, then you will be given a trial,then a month's supply then later on every 3 months you go back to the hub to get your "refill". Simple, right? When available, even the cotrimozaxole and azithromycin are free.

    I know right now, you are confused, but take it from me, who have been there. You will be OK!




    Credit:

    www.freedigitalphotos.net



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    Monday, March 19, 2012

    Facts

    Painful Feet in HIV

    I remembered a fellow poz who have been complaining about painful feet months ago. Another poz had his operation recently and was told that TB maybe the cause of his painful feet. We are still crossing our fingers that it is not. However, TB is an opportunistic infection and can affect any part of the body of an immunocompromised individual not only the lungs. Early detection and treatment is still the key. 

    Because of this, I researched about painful feet and how it is related to TB and HIV.

    What does it feel like?

    Peripheral neuropathy is a long lasting pain that usually occurs in the lower legs. Often it is a burning sensation of the foot soles, sometimes so painful that you cannot walk or even put a blanket over your feet. Your feet may feel cold or numb or you may get a feeling of  pins and needles inside the feet. Sometimes peripheral neuropathy can also cause a tingling sensation in the fingers or around the mouth.


    Who gets it?

    People who suffer from poor nutrition, lack of vitamins or who take too  much alcohol may cause peripheral neuropathy. It is also associated with TB, sugar diabetes and HIV.  Peripheral neuropathy can also occur as a side effect of the TB medication INH or the HIV medications ddI and d4T.  Peripheral neuropathy does not only occur in people living with HIV, although they have a much higher chance of developing it.  It has not been noted in children with HIV.

    What is it medically speaking?

    Peripheral neuropathy is a lack of functioning of your nerves. Thousands of nerves pick up sensations all over your skin. The nerves run through the spinal cord to your brain where their messages get interpreted. In peripheral neuropathy the nerves send wrong messages to the brain and block others. The sensation of a blanket on your skin is registered as pain instead of touch.  Or your brain gets an exaggerated message that your legs feel cold and numb, which makes you put them close to a heater. The nerves block the message that your skin is heating up and you do not feel the pain of burning blisters on your legs.

    Making the diagnosis of peripheral neuropathy

    Your nurse or doctor will be able to make the diagnosis when you tell them your symptoms. The doctor can then test your ability to register pain, temperature and vibrations.

    Staging of HIV

    Peripheral neuropathy can occur at any stage of HIV disease and at any CD4 count. However, it is more common and often more severe in more progressed HIV illness. Peripheral neuropathy is not used for the classification of stages of HIV.

    Treatment for peripheral neuropathy

    Often you will already feel better once the cause of these pains have been explained to you.

    a. If you get peripheral neuropathy while on TB treatment, add Pyridoxine tablets. They counter this side effect of INH.

    b. If you are already using Pyridoxine and still have symptoms, treat it like all other peripheral neuropathy with Amitryptyline.

    c. Amitryptyline was developed as medicine against depression, but at lower doses (1-2 tablets) it can relieve the pain of peripheral neuropathy. It makes you sleepy so you should take it at night. This helps many people who could not sleep well before.

    d. At the moment most nurses are not allowed to prescribe Amitriptyline. To treat people living with HIV more effectively it might be necessary to change this restriction.

    Other medicines

    Some doctors give Carbamazepine (an epilepsy medication) for peripheral neuropathy. It works, but makes antiretrovirals (ARVs) ineffective.  People living with HIV should therefore stay away from Carbamazepine. If the pain is not relieved by Amitriptyline try adding pain tablets like Ibuprofen, Indomethacin or even Codeine and Morphine. Vitamin B Co and Folic acid have not been studied scientifically for treatment of peripheral neuropathy, but some people believe they help. It is also advisable to stop drinking alcohol.

    If you suspect that the peripheral neuropathy is caused by some of your TB or HIV medications, discuss this with your doctor and do not simply stop these medications on your own.





    Sunday, March 18, 2012

    PP Prayer List 2


    I just want to add 2 new persons to the Pozzie Pinoy's Prayer List

    YOU too, can also be a part of this list by emailing me. I already sent the list to a Catholic priest, a head pastor of a big Baptist church here in the country and a Baptist pastor relative in the US, a Mormon Bishop in the US and my brother's group of Monks in the US (and soon a muslim priest, if anyone would recommend me one) and I will send this list to them every week so they too and their communities can help in praying for all of us.

    1. Poz Angel
    2. PositHive
    3. PozzieBoy23
    4. ExofPB23
    5. Ryan HIV
    6. Iamhivpositive
    7. Poz jerry
    8. Casually
    9. Bohemian
    10. Chris HIV
    11. Mike HIV
    12. Kien HIV
    13. Mark HIV
    14. Panga HIV
    15. Rob HIV
    16. Albert HIV
    17. Turvey HIV
    18. Mao Hiv
    19. Jersey
    20. Jayjay HIV
    21. 2ndLease
    21. FB guy
    22. Kiev
    23. Spongie
    24. iampositive25
    25. Paranoid Freak





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