Follow-up appointment

I had another appointment at the clinic yesterday to pick up the results of my CD4 count and to do the fasting blood test. It's funny how you don't mind missing breakfast if it's just that you're busy but all I could think about on the train there was just how hungry I was feeling. I'm hoping that my results won't be too worrying, since getting told my cholesterol was more likely to kill me than my HIV status, I've been rather more careful about what I eat.

Actually, the eating thing was something the doctor and I talked about and she had some really reassuring advice to give me. Since diagnosis, I have lost about 7 or 8 kilos in weight that I've not put back on. I've really worried that this might be because of the virus and she explained that since it seems to have levelled out, then it's probably not something to worry about, but definitely something to keep an eye on. Apparently, when you seroconvert, the action of the virus on your body causes your body to burn calories more quickly, that your metabolism speeds up, which is why, for instance, I still sweat quite a lot at night or sometimes for no apparent reason, that my core temperature seems slightly higher than normal, that I don't get so cold when it's cold, that kind of thing.

However, the weight loss isn't likely to be because of the physical effect of the virus nearly as much as it's going to have been that since diagnosis I've suddenly had a wake-up call about lifestyle things, that I've been eating sensibly out of Cholesterol-Fear and out of a sense that I have to defend my health much more vigourously than before. I've been going to the gym regularly and changed my routine around to be much more focussed on weights rather than cardio and yet I didn't seem to put much weight on, kind of forgetting that doing an hour of weights and five minutes of cardio probably burns as many calories as half an hour of cardio and half an hour of weights, although, if truth be told, I'm spending much longer in the gym, too.

Hearing all this from her, that the changes in my body are not from the virus itself, at least not directly, was an enormous relief - I'd felt that the change in my shape since diagnosis was an unwelcome reminder of being positive, that you could see it in my face that I've lost weight, that I keep my facial hair a bit longer to try to make sure I don't look so thin, that the six-pack that now seems to be burgeoning in my midriff is testament to my work in the gym, not that I'm about to waste away to nothingness. I did mention to her that I've considered taking a course of steroids to make me bigger, but she seemed to think it's more important that I try living with the knowledge that my athletic figure is because I'm getting good results, rather than that I'm dying, so I think I'll give my liver a break and not put myself through that, maybe spending the money instead on a few Personal Trainer sessions.

The other thing we talked about was my anxiety that I might have inadvertantly infected my friend with whom I'd had sex and that had led to me going to get tested for all sorts of nasties just afterwards and I found he hadn't given me anything, but that I was positive. I'm really anxious that it's now three months, and although nothing high risk happened, no major body fluid transfer or anything but that there's any risk at all does play on my mind a hell of a lot.

Oh, yes, you may have noticed that I've not yet mentioned my CD4 count. Well, after the lab lost my last batch and I had to go in on a friday afternoon to get the test done again, apparently Friday afternoon is too late for the lab and they couldn't do anything with the sample because it was too old by the time they got it. I was livid, I'd taken time off work, losing money in order to take the test and again to pick up the results. Incredibly annoying that they then mismanaged my second set of bloods. The doctor, however, was brilliantly incandescant with fury and told the lab I was making a formal complaint and taking legal advice so if they screw up again, they will all be killed in a fireball or something like that.

We also had a brief chat about the whole thing of coming to the clinic at all, about how my politics are against state intervention in private life, so the thought that there will come a time when my life relies on the state for its continuation is something I find quite troubling, so she and I had a pretty revealing talk where she said, actually, CD4 count and Viral Load don't make an enormous difference to outcomes with HIV, saying that even if we take the science as it stands, there's at least four years before I have to even consider HAART so she said I'd be more than welcome to consider options like, after we've established the condition isn't rapidly degenerating, which we would have noticed by now, then I could just go in every 3 or 6 months to get them to take blood, then say I only want to get the results if there's a good reason for me to go in. Or, she said, I don't really have to come back at all if I don't want to, that there's unlikely to be any real need for medical intervention for my HIV status for another four years or so, so maybe only come back when I feel there's a problem rather than when they say I have to come in.

Ironically, I think the knowledge that she's so sympathetic to my beliefs makes me more inclined to keep going to the clinic. It's kind of odd now, that when I'm there, when no-one else is looking, doctors, nurses and health advisors that I've met before give me a smile or a wave hello, not wanting to single me out to the other patients in the waiting area by making it clear I'm a regular, despite my big blue file.

The doctor's agreed to email me the result for my CD4 count and the Viral Load they took again because the last one could have been elevated because of the concurrent infection I had. I'm always going to hate that phrase, incidentally, but it was my request to redo that test just because, I don't know, for someone against state and arbitrary authority, I'm actually pretty autistic when it comes to numbers and I like the comfort that things aren't getting rapidly worse.

So, let's hope I get an email in a fortnight from my doctor, rather than a panicked phone call, but I can't see any reason why I would get one of those when, it seems, I'm deservedly in really rather brilliantly good health.

Ironic, I get HIV, then I'm healthier than before.