Still, Some Concerns

Posted by Pozziepinoy on 8:25 AM
Hi Pozzie Pinoy, 

Its me again. I just want to give you an update on my story. 

Turns our I was right. I am HIV positive. Although what's good is that It didnt phase me at all. It seems that I was ready to accept my fate after all. 

When I had my exam last Monday, they told me to come back as the results came out "For Confirmatory" and in a way I was already preparing myself for the worse. However when I got back 2 out of 3 tests show "Reactive". Now Im just waiting for the Western Blot exam which means that there is still a slim chance that it might come out Negative. 

I had some blood work and an xray done yesterday and all of them came out Normal. However my CD4 count came out at 284. Which means Im going to start ARV treatment tomorrow. What scares me is that "What If I dont adhere to the schedule set by my doctor"

I asked her if I can take my ARVs in the morning as it may be hard for me to adhere to them if I take them at night. What im worried about is the side effects for the first few days or even weeks that I may be lethargic and I couldnt functio  properly for the whole day. 

Im still hoping that in 2 months time that the western blot results turn out to be negative, however there's only a 10% chance that it is. But there is still hope. Maybe my CD4 was low due to the fact that I just came out from medication due to the Shingles attack I had last week or maybe my immune system has finally weakened. But whatever the outcome is, Im still looking for that light at the end of the tunnel. 

I hope to hear from you again. Id love to hear what you think. Your advice helped me came to terms with this diagnoses and Im hoping to do the same for others. 

XXX

POZZIEPINOY'S RESPONSE

HI XXX,

Hello again. Thanks for keeping me and the readers on the loop with your situation. Once again thank you for sharing your thoughts, experience and concerns. By sharing these, you educate others as well.

I am glad that you went to a treatment hub that allowed you to take the lab tests and the CD4 test fast even without the confirmatory. That really speeds up the process of regaining control of your health. Some hubs won't allow this, unfortunately, and would still wait for the Western Blot or confirmatory result. However there are other determinants to the diagnosis. I, for one, was not made to wait for the confirmatory in 2011. I was subjected fast to the CD4 test which my HIV doctor believed was already necessary. Well, it is really a case to case basis, and each hubs' policy. But in my honest opinion and based on experience from the advocacy, delaying the process can often lead to loss to follow up clients. Delaying the process may also lead to not diagnosing the presence of other infections that can be treated immediately. Like in my case, prior to the management of my HIV, my HIV doctor addressed first my opportunistic infection. The opportunistic infections or AIDS related infections are the ones that are the killer, not HIV per se. Treatment of HIV may take a while, meaning it will take a while for the body to regain and recover its immune system, usually after 6 months, thus priority is treatment of the deadly OI's. However, some doctors do this at the same time, therefore, like what I said, it is a case to case basis. What is important is the speed of treatment being given to you because focusing on treatment and how it works leads to a better acceptance of HIV. Early treatment also arrests the HIV from being transmitted to others.

Now you know your CD4 count which now tells you that you need to take the antiretroviral medicines or the HIV medicine. Although included in the World Health Organization ARV guidelines that all newly diagnosed individuals should take ARV's regardless of the CD4 count, in the Philippines, we still follow this rule: CD4 of 500 and below, ARV is recommended, and CD4 of 300 and below, must take ARV's. This may be related to the supply of our medicines here that are currently free from the Department of Health. Soon, this will be paid for by the trust fund established by each hub, the fund of which will come from PhilHealth. It is also good to know that you don't have any infections which may reflect the state of your immune system.

Let's go down to business. I don't know what ARV's have been prescribed to you, but your doctor has already initially fully assessed you based on your labs and your job so she knows what to give you. Initially there maybe side effects. I said "maybe" because some really didn't have side effects at all. In my case, I did my research on the medicines that were given to me and I knew before hand the side effects and how to combat them. For instance, I was prescribed with efavirens, the immediate side effect of which is dizziness and vivid dreams. On research, I found out that these side effects come out if I take it on full stomach. So in one year, I took my ARV's containing efavirens 3 hour after my last meal. No side effects. Also, I belonged to 1% of those who will have rashes because of efavirens. I sensed that this medicine makes me feel hot and itchy. I remembered that if I'm hot and itchy, I almost always have rashes, so what I did, was I took frequent baths and applied cooling powder and lotion. Alas, no rashes. If you followed my stories during the first months of this blog, you will find that I had rashes for a maximum of 3 days. To date, I am still taking the same ARV's and sometimes I would get dizzy when I take them when my stomach is full. Although the long term side of effect of efavirens is cholesterol build up, I combat it with an active lifestyle and frequent going to the gym to burn off excess calories from fat. My ARV's work for me based on my undetectable viral load for 5 years now.

My advice to you is to research your ARV's. It is better to empower yourself with the knowledge of them and their side effects. By knowing the side effects, you can combat and help prevent them. 

Do not be scared. Fear can lead to inadvertence. Talk all the time to your doctor. She can adjust your ARV schedule if needed, and there is nothing to worry about that. What is important is to find a schedule that will work for you and your job. A schedule that is not fit for someone can lead to  non adherence. Remember, adherence is very important to managing HIV. Please don't take it for granted. Some of Project Red Ribbon's clients become non adherent because of work schedules. Inadherence leads to resistance to the very medicines that are managing HIV. Inadherence can lead to further degradation of one's immune system. Inadherence can result to the coming out of the opportunistic infections which to a weakened immune system, can be life-threatening. Also, the Philippines has only a very limited options of ARV's and moving to one regimen to another because of ARV resistance, may eventually result to exhaustion of all possible options. When this happens, the next line of one medicine may cost you up to P20,000 per bottle a month. Then avoid non-adherence.

The HIV tests given to you are definitive of HIV. The CD4 cells are the target cells of HIV and based on your CD4 count, HIV has started wrecking havoc on your CD4 cells. Focus on the treatment now and you will come to terms with yourself fast. Accepting fast can lead to an early success of managing HIV. Trust me. It worked for all of us people living with HIV.

I hope that I was able to answer your concerns and gave you some insights. Please do email again if you have other concerns. The Blog has  a reach collection of knowledge and personal stories. Study and learn and get empowered.


Stay healthy,
Pozziepinoy




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