RITM, day 2. This entry may as well have been entitled another day with… needles. Imagine me cringing.
It just happened to fall on another Thursday. I had been scheduled by Ate and the doctor for my lab tests at the RITM. I had planned on taking another day off from work, but reconsidered, thinking I’d save my leave credits for other more important appointments. I had been given the option of showing up early at the RITM. And I mean early. As in 6:00 am. Early enough so I’d be able to make my way back in time for work at 8:30. At least that was the plan.
Instead, I mistakenly left my cellphone in silent mode, missing my wakeup call by about 45 minutes. Instead of getting up at 4:45 am, I ended up realizing my mistake at 5:30 am, and just rushed to get out of the house. I had planned on making the first trip of the MRT, but obviously missed it. I was able to take the train at 6:00, not too bad. I love traveling that early in the morning. It was still pre-rush hour, a big advantage for the claustophobe like me. It was around a 20-minute train ride, from which I rushed down to street level to hop on a bus plying the Alabang Skyway route. I was just trying to recall how U took me to the RITM last Monday. Plus it made sense, it was a route straight to Alabang via the Skyway, meaning less stops, making for a faster trip.
It was a long but quick bus ride, and I tried to take note of landmarks on the way. We passed by the Nichols Exchange, the farthest south I was really familiar with, since that was where my first boyfriend was from. Further on down, we entered the skyway, and passed the Raya residential development which looks amazing. We passed the Hapee Toothpaste plant, the SM Mall in Bicutan, an finally exited at what looked like a newly constructed Alabang Exit which led into the Filinvest Corporate City. I got down where U and I did previously, at he Alabang Central Terminal.
I decided to walk towards the RITM instead of riding, primarily because I get a better sense of direction when I’m on foot. I retraced the steps we took last Monday, walking towards the Festival Mall and up towards the hill where the RITM was situated. It was a long walk, and I made it before 7:00 am, but remained unconvinced that I had taken the shortest way.
I first walked towards the comfort room, to relieve myself of the pee I’d had brewing in time for my urinalysis. I needed to keep it in almost the whole way, since I’ve been known to suffer from a shy bladder at times. I whipped the bottle out and filled it up mid-stream as advised. Then off I went to the Laboratory Department, which U had pointed out to me during our earlier visit. There was still no one answering the doorbell, so I sat down on a bench in the hall trying to cool off after the long walk. A few minutes later a lady passed me and walked into the lab, shortly after peeping out the window asking if I was a client. I handed her my lab referrals and the urine sample as she ushered me in. I sat down in the torture chair, putting my arm down on the armrest ready for my sentence. She looked at the list of test to do… viral load, CD4 count, genotyping, CBC, hepatitis profiling, and urinalysis… and whipped out four vials to fill. Four vials? That’s worse than the three I filled up at the Manila Health Department months earlier. This would be a record for me. Or so I thought. I looked away as she started to push the needle into my arm. I’m getting used to the feeling, but still can’t stand seeing it. Next thing I know, she’s asking me to hand her two more vials from the table next to me. Four? Plus two? Another record broken… but I have to admit it wasn’t that bad. So there I was, six vials of blood lighter, a survivor.
I walked next door to the X-ray Department, again no one was there. There’d been a sign saying the personnel were at the canteen, so again I sat down and waited. The old lady in charge soon showed up, and I was in and out of there in a flash.
Last stop, some test called PPD. Research now tells me it stands for Purified Protein Derivative, a skin test for tuberculosis. I had been pointed to the emergency room for it, from where I was pointed to the Pharmacy. I showed the referral, and I was given a box of something called Biocin, and told to return it after. Weird. Not something I’d usually hear at a pharmacy. So I returned to the E.R. and handed it to the nurse, who asked for my chart. Chart? What chart? I had nothing else with me but the referral, but was told they couldn’t do the test without the chart. I tried texting Ate, but received no reply. U had given me her number beforehand in case I encountered some problems. So I had to wait, thankfully she arrived early, around 8:30 am.
Needless to say at this point, I didn’t make it to work on time. So anyways, Ate accompanied me back to the E.R., and gave her personal referral in order to push the test through. So apparently, PPD is a skin test. And I must say skin tests hurt. I got a bump full of the medicine in my arm, had the nurse draw a circle around the test site, plus a note on a piece of tape on my arm with the date and time it was administered. Bad enough that I couldn’t wet my arm for three days, but I had to have the pen mark and the tape on me at work. Hmmm. I have some explaining to do.
Take note again, that all the tests I had done were free at the RITM, except for the P120.00 I paid for the Biocin thingy. I’m told the test will be free everytime, as oppose to that at San Lazaro, where follow-up CD4 counts cost something like P4,000.00, and viral load tests P6,000.00. That should be more than enough savings to pay for the additional transport to the RITM.
I realized I didn’t bump into any other fellow clients, Ate being the first and only person I encountered from the OPD that day. I was out of the RITM by 9:00 am, already having sent a text message to work saying I would be late. I walked back to the highway, but this time following my instincts and passing a road I hadn’t tried before. I think I got the right and shortest route this time. I made the trip back, via the bus and the MRT again, and reached work past 10:00.
Another amazing day, not even half through, but already got a lot done. Just two tests left, a fecalysis and RPR titer. A stool sample would spoil in the length of the trip, while the latter test, they didn’t have at the RITM. I’m thinking of going back to Dra. Malou at the Manila Health Department for those tests, as well as to pay them a visit and update them on my status. I’m planning to do that Tuesday morning, another day I’m taking off from work. A bloody and shitty Tuesday, literally.
I have another visit to the RITM scheduled on Tuesday afternoon for a consultation with the doctor. I’ll find out the results of the tests, plus my options for ARVs. So it’ll be another busy week again for me. My verdict is coming… again. Wish me luck!
Sunday, August 17, 2008
A Day w/o U
Friday, June 27, 2008
Yahoo!
I apologize. I’ve been meaning to blog since yesterday, but never got the time, nor the energy, until today. Finally.
I do have something big to write about. Well, it's big to me, at least.
Yesterday brought some news, the best I've gotten in the very recent past.
Let me introduce… H. This H guy has been part of my journey ever since. A silent party maybe. He’s the first person I told when I got my results. I don’t even remember how it happened, but it was something like we got tested the same week, and while he got his results a day after, mine had taken a while, as you can recall. He told me his was negative, and was eager probably to share my relief when I was to find out I was negative. But that time never came. He knew I was waiting for the results, so I had to tell him. He’d figure it out somehow if I didn’t tell. So I told him my bad news.
Now, the catch is, H and I had been buddies for a couple of months before we got tested. Yes, buddies. Yes, we were a perfect match. Yes, we were doing it. And yes, at times unprotected. So he has been hanging in the balance since mid-March, waiting for the three-month window to pass before getting retested. We’d been regularly chatting during this period. I updated him on my check-ups, and he updated me on his paranoia. Some days he’d feel some things that he thought could be symptoms, other days he’d tell me he felt he was negative. I don’t know how much of this blog he’s read, but he knows about it definitely.
Finally, he was able to get tested this last Wednesday. The three month wait to get tested may have been torture for him, but I’m sure the 24-hour wait for the results was worse. I told him I’d be praying for him, and pray I did.
Finally, the day came. A Thursday again, coincidentally. Big day Thursday. He sent me a text message, saying he didn’t know how it happened… but he was negative. Negative! OMG, that’s the best news ever! And I’m sure I had a my share of a sigh of relief at that moment.
I always thought his next steps would be to head on off, go on with life, disassociate himself from me, and just be more careful in the future. But he surprised me. In the next message he sent, he told me to take him off my guilt-list and add him to the reliable-buddies-list… It was just really, really touching to hear that. Something I didn’t ask for or expect at all.
I’m truly blessed to have encountered someone like him. I knew before that we were good together physically and intellectually, but now emotionally as well. I’m sure he knows it’s him I’m talking about. And I’m sure he’ll agree, this was a very unusual, but great start to one hell of a friendship.
At least I know one person is celebrating this weekend… And so I say, STAY SAFE!!!... in every possible way… wink, wink…
Friday, June 06, 2008
Ear Drummed
Yesterday was a lot to think about.
But come to think of it, this past Thursday at H4 was equally a workout for my brain, with all the thinking and paranoia, as it was for my ears, with all the chattering and cackling I witnessed there.
Just waiting by the door as soon as I got there, an old lady walked from the ward and sat down across from me, and started chatting with me. She was the mom of one of the patients confined there. I felt she needed someone to pour out to, so I even stood up to sit beside her. She just went on about her son's condition, that he was gay (I don't know if she realized I was gay too), that the virus had affected his eyes, and about how her other children had abandoned their brother. A bit depressing to hear their story. But I assured her that she was a hero for the good job she was doing.
Another woman who passed us, the wife of another patient, was rambling about tests and blood donations needed by her husband.
Soon, with more than ten of us sitting out there, I was hearing about everything from the need for drinking water in the ward, ARVs they were taking, donations for school supplies for this coming school opening, to CD4 counts, Pinoy Plus meetings, and whatever else.
One of the guys was confined for a "re-trial", since the first ARV he was given caused him to get rashes and fevers. So this is what I'll have to deal with when I get to that stage, I remember myself thinking.
One other girl says she wasn't on ARV's, jokingly pointing out that her CD4 count should've shot up with her weight.
I even learned a new term. Everyone there kept mentioning the word pusit, which is actually tagalog for squid. I was tempted to ask What's with the squid?, but soon realized they weren't talking about squid. Apparently they use the term Pusit as a nickname for us Pusit-ives or Positives. I had to laugh when I realized that.
Several noticed the newly painted neighboring ward, and mentioned that we pusits should take over the building because it was nicer. A good idea, if only it weren't the Tuberculosis ward. Remember, we don't mix well with TB.
Each one had his or her own story to tell. So many different people, brought together by a supposedly not-so-good thing... it was amazing.
Too bad I was called away by the doctor, and didn't feel like sitting back down after the talk with the doc. But irregardless, still amazing.
Thursday, June 05, 2008
Brain Overload
My Thursdays still have not managed to let my guard down. Again, it was H4 day. I was out of the house by 7:00 am, and a tricycle and a jeepney ride later, I reached the HIV ward of San Lazaro Hospital. It was just 8:00 in the morning, and lo and behold, I was first on the list!
I don't think they expected anyone that early, so the nurse just sat me down by the seats by the door of the building to take a breather, before they took down my vitals and while they finished their duties and reports.
After some time, more people poured in, and I gamely sat in their midst. It was not exactly in my comfort zone to mingle, but it was nice. I was finding it a bit hard to keep up, but I surprised myself by being comfortable in that crowd. There were around 20 of us there, and I got acquainted with a number of them, as they introduced me as "the new one".
I noticed a couple of them whip out what looked like white bank passbooks. I read what was written. Health Regimen Booklet. Hmmm, so I figure this is how their ARVs are monitored. I wasn't looking forward to getting one of my own though.
By 9:00 am, the doctors came. My usual doctor wasn't there. So the other doctor and a new one were on hand. They started off making rounds of the ward and checking on those confined. By about 9:30, they headed for the doctors' office and I was called in shortly.
She already had my folder on her desk, but still asked my patient code. She then flipped through another folder, where she was looking for my CD4 test results. Finding it and taking it from the folder, she sat down and looked at me sternly. She asked me some old questions again, like who knows, if I had a partner, and how I'm dealing. She reiterated the need to tell someone in the family. Rebriefing I guess.
At this point, she stared at my results, and asked me what I wanted to hear. Whether I wanted to hear the number flat out, or just if it was bad or good. I sort of giggled a bit at the question, and just said I wanted it all. She still held back a bit, looked at me, and said it was below 350. My mind raced at that point, but I kept a straight face. Normal is above 500, so it's not that good. But how far below 350? The critical 200 was below 350. Absolute zero was below 350, too. Tell me! Tell me!
Finally, she said it. My CD4 count is 343. Not entirely bad, but not good either. Almost midway between normal 500 and critical 200. She then said that she'd advise I get started on ARVs. But not before more counselling. And not before I have a support system behind me. Family preferably. Friends possibly. Anyone really. I said I was planning to tell my sister, and realized this development just made it more urgent. A lot to think about in the coming days.
The doctor then sent me off, but not before leaving me her mobile number, so I could contact her when I was ready to get counselling with whoever I chose.
I was honestly a bit defeated that I wasn't doing as well as I was feeling. I bid goodbye to my new friends out front before heading off back to work. I didn't even drop by the Social Hygiene Center. I was planning to just check in on Dra. Malou and the gang there, but suddenly didn't feel like it. Maybe another time, when I was less distracted.
I'm a bit glad that I have work to think about, and colleagues to laugh it up with and get stressed out by. But I won't be avoiding this for long. I'm left with a lot to think about right now. Head... hurts... hehehe.
Thursday, May 29, 2008
H4 Galore
Another big Thursday for me. I left around 7 am, but not before talking with K over the phone. He just called to send me off on what he thinks is another regular work day for me. Little did he know.
So I made it to the HIV ward of the San Lazaro Hospital a little past 8 am, had myself registered, and my vital signs taken. H4-2008-054. Weight is still the same, blood pressure normal, temperature was a bit high, I’m thinking because I had barely taken a breather before they sat me down to take it. But I was feeling fine.
I noticed some of those metal medical clipboards on the counter, probably records of those confined. I noticed that the patient codes were written on the top of the clipboards, one of which I read as H4-2008-059. I realized, geesh, at least five other people have already been diagnosed after me. And whoever this is, his condition has called for him to be confined. I’m pretty lucky then.
I walked into the waiting room, and sat down. There were three other guys already there. One of them I recognized to be the guy trying to smile at me when I was there two weeks ago. A bit surprising, since he has been checked-up at least twice this month already. He recognized me, smiled and went back to reading his newspaper. The four of us continued waiting since the doctors hadn’t arrived yet.
After a while, Y walked in and started chatting up with all of us there, who he knew apparently. It was nice to see a familiar face. He still treated me as the new kid, which was nice.
I heard voices from the reception counter, later on realizing it was the other doctor. She called for me, and instructed the nurse to hand me my referral slip for the CD4 count. I was pointed to the direction of the SACCL, short for STD/AIDS Central Cooperative Laboratory. Their name was also on my diagnostic results which I got last April. Apparently this is where most of the STD related tests are done, such as Hepatitis, HIV, Venereal Disease, etc.
But before going, I noticed the guy getting his vital signs taken, looking at me. He was cute. He seemed like an older guy, smaller, fair, manly, a bit stocky, dignified, and a bit shy. My type. I don’t know what his name is, but he was looking at me, and I was looking back. I still wasn’t hell bent at using the ward as a cruising place so I picked up my heels and just headed to the SACCL.
Walking to the next building, 8 or 9 people were waiting before me. I had to spill over to the waiting area outside the building where one other guy was. He asked me what I was there for, explaining he was there for a medical test for Hepatitis required for his application to the Philippine National Police. I don’t remember what I answered but I’m sure I couldn’t have been vaguer. Hahaha.
When it was the turn of the guy in front of me, I could hear from the voices in the lab that something was wrong. The guy first walked out with a cotton ball taped to his left arm. Going back in, he later walked out with another cotton ball on his right arm. Still they weren’t done. I don’t know where the hell else they took his blood, but this was scaring me quite a bit already!
Then my turn came. Oddly enough, they asked me to write my real name on the referral form, contrary to what I believed was a confidentiality law for HIV infected persons. If I were a fraction of sensitive and defensive, I would’ve put up a fight. But I wasn’t, so I penned my name away.
Then I saw the needle. It was bigger than my usual and it hurt going in. Then I felt the lady pushing and pulling and wiggling it around in there. My blood wasn’t flowing?! It was a problem with some adaptor they were using. It was hurting like hell! I’m still squirming right now recalling the pain. Then she just said sorry and pulled it out. Next arm. She had left me with a big red pock on my left arm, and had no blood to show for it. Thankfully she got it on the second try. I’ll need my phobia to heal again after this.
So anyways, I headed back to the ward, half wishing I’d catch “the guy” still there. I went in to see my doctor in the doctors’ office for less than 3 minutes, faced another one of her pity-faced are-you-sure-you’re-okays, and headed out. I didn’t see him there. I wasn’t sure, but good thing I waited because he had been talking with the other doctor the same time I was inside. So anyways, I saw him again, we exchanged nods a bit, but never talked. Y felt the need to keep me company, so I didn’t get the chance to work the guy over. I hope I bump into him there again sometime.
I’m beginning to look forward to San Lazaro. I’ll be back at the ward next Thursday, mostly to discuss my CD4 results with the doctor, but partly hoping to meet more pozzies as well. If I’m lucky, maybe I’ll see “him” there again. Man, I’m a slut!
Tuesday, May 27, 2008
Count Down to Count
I just heard back from the doctor of the HIV ward of the San Lazaro Hospital, and she's confirmed my appointment on Thursday for my CD4 count.
I'm getting a bit of nerves again, both about the ward's Thursday crowd, and the test as well.
So to at least equip myself for the latter, I've been doing some research.
What are CD4 Cells?
CD4 cells, also known as T-cells, are a type of lymphocyte or white blood cell. An important part of the immune system, CD4 cells come in two main types. T-4 cells, or CD4+, are "helper" cells which lead attacks against infections. T-8 cells (CD8+) are "suppressor" cells that end the immune response. CD8 cells can also be "killer" cells that kill cancer cells and cells infected with a virus.
Why are CD4 Cells Important in HIV?
The cells that HIV infects most often are CD4 cells. The virus becomes part of the cells, which when multiply to fight infections, also make more copies of the HIV. The number of CD4 cells (their CD4 cell count) goes down when infected with HIV. The lower the CD4 cell count, the more likely the person will get sick.
What Factors Influence a CD4 Cell Count?
The CD4 cell count varies a lot. Time of day, fatigue, and stress can affect test results. It's best to have blood drawn at the same time of day for each CD4 cell test, and to use the same laboratory.
Infections and vaccinations can cause CD4 and CD8 counts to go up. It is advised to have CD4 cell counts at least a couple of weeks after recovering from an infection, or getting a vaccination.
How Are the Test Results Reported?
Reported as the number of cells in a cubic millimeter of blood, normal CD4 counts are between 500 and 1600. CD4 counts can drop to as low as zero in people with HIV.
What Do the Numbers Mean?
The CD4 cell count measures the health of the immune system. The lower the count, the greater damage HIV has done. Anyone who has less than 200 CD4 cells is considered to have AIDS according to the US Centers for Disease Control.
CD4 counts are also used to indicate when to start certain types of drug therapy such as antiretroviral therapy, aggressive retroviral therapy, and drug prescriptions to prevent opportunistic infections.
The complete article can be found at http://www.thebody.com/content/art6110.html.
Wish me luck.
Thursday, May 08, 2008
Post-Thursday Thoughts
I'm physically tired by this time. I've had a very long day. But my mind keeps racing. I just have to get this out lest it keep me up all night.
Looking back at the day that just passed, I realize what a relief it was. Not just because of the lab results I got, but because it was great to see I'm not alone. Being in HIV ward was relieving. I'd never met anyone living with HIV before I stepped into San Lazaro. I'd only seen them on the web, and in tv documentaries. I never imagined I'd be one. But spending a short time in the waiting room of HIV ward was... eye-opening. There are others like me. All kinds, all shapes, all sizes. From twinks to hunks, you name it, you got it. I prefer the hunks though...
Wait... was I cruising?! Geesh! I was!
Okay, okay, so I suddenly snapped out of my trance and decided to become cruisy. How couldn't I? I have HIV, and based on my shallow philosophy that someone with HIV can't catch HIV any further, it should be logical for me to gravitate towards fellow HIVers, right? And to be in a room of pozzies, ahhh heaven.
Okay, okay, I'll stop now. Mojo would not approve.
My point should be that looking at the variety of people there, men and women, young and not so young, twink and hunk, they all looked... normal. Other than a few who had visible skin discolorations or rashes of some sort, you could never tell they had it if I threw them in a room of people. Good for the paranoid like me. Bad for those who use protection based on whether their partner looks like he has it or not.
Anyways, I jut thought I'd share this breakthrough of a moment before I went off to lala-land, when, just for a few minutes, I realized that... I'm not so different after all.
The Thursday
Walking towards the HIV ward, I didn’t know what to expect. How big a crowd would I be in there? Trust me, I’m no good in crowds. I was just relieved that I didn’t see a line formed a block away from the door.
Walking up the steps, I passed some seats where people were waiting. There were about 5 or 6 of them there, but they were all a blur to me. I was trying not to make eye contact. Paranoia, I’m guessing.
I approached the nurse up front, and said the doctor asked me to drop by. The nurse asked if I was there for a checkup. I answered that I didn’t think so. She said that she’d list me down if I was there for a check-up. I just know that the doctor was expecting me back today to give her the results of my lab tests. It didn’t seem like a real checkup for me. At least, not the checkup that I was familiar with. She said the doctor wasn’t there yet, and asked me to sit in the waiting area.
So I sat. There were three others there, a woman with a younger guy on my right, and a guy across me. I saw the woman was wearing a face mask, and realized despite this, I couldn’t tell which one was the patient. I noticed the guy across me trying to work in a smile while looking my way. Was he flirting? Or was he just being friendly? Was he new here too? Or was he laughing at me for being the latest victim? Paranoia again. Turns out he was poz too. I realized that when he was called into the doctor’s office.
One after the other, they rest of the people there, less than 20 of them, got called in for their checkup. They would spend just between 5 and 10 minutes each inside. Not bad. Routine monitoring, I guessed.
Then one older guy approached me. He introduced himself. Let’s call him Y. He didn’t seem like he was there for a checkup. Sort of supervising… and mingling. He seemed to know everyone, and asked what I was there for, and asked me to have myself put on the list out front. He said it was standard procedure, despite my trying to explain that I didn’t think I was there for a checkup technically. But he came across a bit territorial to be honest, so I just followed his advice.
The nurse took down all my information – patient code, code name, weight, temperature, blood pressure – after which Y led me back to the waiting area. He was a bit more relaxed now, and started a conversation. Apparently, he’s been poz for a while now, but definitely in the peak of health, and was there to oversee the procedures. Sort of assistants to the doctors. For public relations and other concerns if I understood right. He was having such a difficult time asking me if I was a confirmed poz, which I found funny. So I just blurted out, “Yes, I’m HIV positive”. I think I relieved him of his burden. He explained most of the going-ons there that moment, and introduced some of the personalities there. My nerves eased up at this point and he got me talking a bit about myself.
In the midst of our conversation, the doctor walked in. Seeing me, she smiled and signaled to wait a bit, probably to give her time to settle down. The next time she stuck her head out from the door of the doctors’ office, she asked what my patient code was. A few more minutes later she called me in. So I was right, I didn’t have to line up with the others in the “checkup” queue. Whew.
Sitting down in front of her desk, I handed her my lab results, as she ranted about why she was late that day. She took a look, and said I was ok. Say what? She repeated that my lab work says I’m doing good, and just reminded me that I was scheduled for my CD4 test on the 29th. I wasn't even in there for five minutes. But anyways, another whew from me. I was just happy that I was ok.
So from there, she sent me off, and I left some final words with Y who I passed. He took my number and gave me his, as he said he’d like to invite me to join their group sometime. Something called Pinoy Plus. I’ll tell you more about that when I find more out.
So I left, a bit triumphant. I just had to spread the good news, so I dropped by Dr. Malou Tan at the Social Hygeine Clinic across the street. She was happy, and I was happy. Nurse Luz and Dr. Diana were there as well, and they were happy to see me, too. Dr. Malou is great. I feel she truly cares. She’s like a mom to me now. Maybe she can be my HIV mom.
So anyways, it was 10:30 am, and I had accomplished a lot. I started my journey to work. Back to my regular life. Or my former regular life. The parallel world I live in, where Thursdays are just like any ordinary day.
