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.
Saturday, November 12, 2005
Monday, November 07, 2005
Settling In
I wonder why I'm feeling an urge to think about other people I know with the virus and compare my angst about it to theirs, as though there's any kind of merit in saying that my infection has upset me any more or less than it has for other people I know. I mean, I have friends for whom it has become the centre of their life, where they make art around the idea of their infection and you can't talk to them for an hour without the topic being brought up one way or another. Equally, I have friends who I can't help but wonder are in denial because they're out doing all kinds of self-destructive things and perhaps are literally running themselves into the ground.
It's been three months, just one season that's shifted from late summer to a definite autumn and I think on the whole I am pleased with how my thoughts have mellowed on the whole issue of being infected. It might just be that now I'm talking about it less that it sits less on my mind, but it has become something of a joke between my partner and me. If, say, I have a headache, we blame the AIDS. If he stubs his toe, it's the AIDS.
It's not some sword of Damocles hovering over our heads, waiting to fall and slay us both, but it's the knowledge that at some point in the future, we're going to step out into the road and be hit by a bus. Until we're actually ill with this thing, it's hard to know what to do about it.
It's been three months, just one season that's shifted from late summer to a definite autumn and I think on the whole I am pleased with how my thoughts have mellowed on the whole issue of being infected. It might just be that now I'm talking about it less that it sits less on my mind, but it has become something of a joke between my partner and me. If, say, I have a headache, we blame the AIDS. If he stubs his toe, it's the AIDS.
It's not some sword of Damocles hovering over our heads, waiting to fall and slay us both, but it's the knowledge that at some point in the future, we're going to step out into the road and be hit by a bus. Until we're actually ill with this thing, it's hard to know what to do about it.
Monday, October 24, 2005
Round Two
Well, seemingly I spoke too soon about sex with other positive guys being less complicated and wound up in the clinic getting antibiotic jabs. I guess that's just another indication that nothing's changed. I also picked up my new viral load count, but they lost my CD4 count. I did jokingly ask the doctor if that meant I had a CD4 count of zero, but they took the blood again. It seems I've spent the main part of the last few months with tracklines on my arms from one blood test or another. My viral load is now 41,000 or something, which rather throws my hopes that I was such a recent infection that my viral load was going to get lower.
I didn't really want to think about it at the time, but it could be an anomalous result because, as the doctor said, I had a concurrent infection. It's slightly daunting to think that every time I get ill, it will be with a concurrent infection. Just another reminder that I carry a spreadable disease.
I guess that's the rub with HIV. There's all the drama and the novelty of the initial infection, then there's just this gnawing constant because it will never go away. Any infection from now until the day I die remains a concurrent infection. That's a deeply unpleasant thought, although one to keep in perspective. Having a lower viral load isn't some kind of contest, there's no moral weight attached to being less infectious. It's not like there's some correlation between your numbers and the circle of hell to which you will descend.
I know, intellectually, that it's a minor fluctuation in the scores, and likely one to do with the concurrent infection I had at the time, but I can't help but shake the feeling that, oh, God, it's double what it was. I'm twice as infectious as I was when I was diagnosed.
I suppose it would pay to keep that in mind when I start to get complacent or whenever anyone thinks to convince me of the merits of barebacking.
I didn't really want to think about it at the time, but it could be an anomalous result because, as the doctor said, I had a concurrent infection. It's slightly daunting to think that every time I get ill, it will be with a concurrent infection. Just another reminder that I carry a spreadable disease.
I guess that's the rub with HIV. There's all the drama and the novelty of the initial infection, then there's just this gnawing constant because it will never go away. Any infection from now until the day I die remains a concurrent infection. That's a deeply unpleasant thought, although one to keep in perspective. Having a lower viral load isn't some kind of contest, there's no moral weight attached to being less infectious. It's not like there's some correlation between your numbers and the circle of hell to which you will descend.
I know, intellectually, that it's a minor fluctuation in the scores, and likely one to do with the concurrent infection I had at the time, but I can't help but shake the feeling that, oh, God, it's double what it was. I'm twice as infectious as I was when I was diagnosed.
I suppose it would pay to keep that in mind when I start to get complacent or whenever anyone thinks to convince me of the merits of barebacking.
Sunday, October 16, 2005
The Blue File
Well, I've been back to the clinic, had some more blood taken. I had a virus (another virus) at the time so I wonder if that will have dented my CD4 count when I pick the results up in a couple of weeks. Sitting in the clinic waiting room, I found myself thinking about my HIV status for the first time in a couple of weeks. To be honest, it doesn't play on my mind nearly as much now that the initial novelty or horror of it has worn off and there's still bills to pay, still work to do, still people to see.
After sitting there for a few minutes, I noticed that my file was a thick, blue, ring-bound file, whereas most of the other people there had thin, brown paper files. Clearly, the thick files are for HIV+ patients and I did kind of have a little bit of a sad, yearning moment there for the time when my file was a thin, brown paper file. It's probably not really brilliant in terms of disclosure that there is this differentiation, because after my initial sadness at being the only blue file case while I was waiting, a few other guys came in and after fifteen minutes of watching people going in to see doctors, nurses and health advisors, I knew the HIV status of all the people waiting there that day.
I talked to the doctor, who was very friendly and reassuring, mainly just to check in with them to know that I'm okay, which I am on the whole. It's still a learning curve, and I'm realising now that it's not some scythe hanging over me, it's not some black mark on my forehead, seared in my skin. The stuff in the papers about how HAART resistance is increasing and how HIV resides in the brain is hard to take, partly because of the way the papers talk about HIV infected people as some kind of "Other" which has a strange impact on how I feel I fit into society if I am suddenly some invisibly different and dangerous chameleon.
I also talked to the doctor about my moles, she's going to write me a referral letter to the dermatologist at the hospital to talk about options. I'm currently of the thinking that I'd like rid of every last one of them, but I don't think they would recognise that as a clinical need.
I've stopped thinking that every time someone doesn't text me back, say they're up for a shag when we used to shag or they don't reply on gaydar that it's because I'm positive and they hate me for it. Of course, that's only the people who I know now know, though, and that's not a pool of people I would like to see increased. The people who know, on the whole, it is on a need to know basis, that they're either likely to come into contact with me sexually, my blood, or that they are the people I turned to in what I thought was my darkest hour of recent months. I'm okay with those people knowing, and I really do appreciate the support and love I've been given during that time, but, for instance, one guy who knows doesn't seem to talk to me so much, I wonder if that's just that we've drifted apart and another guy I am less keen on spending time with than I was when I told him. I'm not so anxious that I think I need to keep him on-side in case he goes out and tells everyone. "So what?" would be the key response, I think.
After sitting there for a few minutes, I noticed that my file was a thick, blue, ring-bound file, whereas most of the other people there had thin, brown paper files. Clearly, the thick files are for HIV+ patients and I did kind of have a little bit of a sad, yearning moment there for the time when my file was a thin, brown paper file. It's probably not really brilliant in terms of disclosure that there is this differentiation, because after my initial sadness at being the only blue file case while I was waiting, a few other guys came in and after fifteen minutes of watching people going in to see doctors, nurses and health advisors, I knew the HIV status of all the people waiting there that day.
I talked to the doctor, who was very friendly and reassuring, mainly just to check in with them to know that I'm okay, which I am on the whole. It's still a learning curve, and I'm realising now that it's not some scythe hanging over me, it's not some black mark on my forehead, seared in my skin. The stuff in the papers about how HAART resistance is increasing and how HIV resides in the brain is hard to take, partly because of the way the papers talk about HIV infected people as some kind of "Other" which has a strange impact on how I feel I fit into society if I am suddenly some invisibly different and dangerous chameleon.
I also talked to the doctor about my moles, she's going to write me a referral letter to the dermatologist at the hospital to talk about options. I'm currently of the thinking that I'd like rid of every last one of them, but I don't think they would recognise that as a clinical need.
I've stopped thinking that every time someone doesn't text me back, say they're up for a shag when we used to shag or they don't reply on gaydar that it's because I'm positive and they hate me for it. Of course, that's only the people who I know now know, though, and that's not a pool of people I would like to see increased. The people who know, on the whole, it is on a need to know basis, that they're either likely to come into contact with me sexually, my blood, or that they are the people I turned to in what I thought was my darkest hour of recent months. I'm okay with those people knowing, and I really do appreciate the support and love I've been given during that time, but, for instance, one guy who knows doesn't seem to talk to me so much, I wonder if that's just that we've drifted apart and another guy I am less keen on spending time with than I was when I told him. I'm not so anxious that I think I need to keep him on-side in case he goes out and tells everyone. "So what?" would be the key response, I think.
Monday, October 03, 2005
Run Down
I've thought much less about being positive this week, which I think is a healthy sign. Had sex with one guy this week who was positive which was so different to the experience the week before, not just in terms of different men having different bodies and different personalities, but in terms of the anxiety just not being present. Perhaps I should still be anxious about re-infection, but the evidence doesn't seem to be there for any indication that having different strains of HIV makes any difference to your prognosis. Nevertheless, until this year, they didn't think fucking someone without a condom was high risk and look at where I am now as a result of that ignorance.
In any case, I don't think that by any measure the psychological impact of reinfection would be anything like infection in the first place. I know that it's starting to sound like serosorting, but I'm not going to analyse it to that point if I can avoid it. It's just as likely that I was more relaxed this week because I'd processed all the guilt and shame that went with the guy's concerns the week before. I'm pretty sure it's largely that, because the guy who I said had freaked out has been sending me friendly texts and stuff and not mentioning it again, so it probably was more of an issue for me rather than him.
You know how they say in safe sex stuff about how people tend to assume people have the same HIV status as themselves? I'm kind of worried I'm starting to do that. Whenever a friend says they have a cold or anything, I assume it's because they're positive. This is something I'd really like to nip in the bud, and it's probably another projection of my own anxieties about my status onto other people.
In any case, I don't think that by any measure the psychological impact of reinfection would be anything like infection in the first place. I know that it's starting to sound like serosorting, but I'm not going to analyse it to that point if I can avoid it. It's just as likely that I was more relaxed this week because I'd processed all the guilt and shame that went with the guy's concerns the week before. I'm pretty sure it's largely that, because the guy who I said had freaked out has been sending me friendly texts and stuff and not mentioning it again, so it probably was more of an issue for me rather than him.
You know how they say in safe sex stuff about how people tend to assume people have the same HIV status as themselves? I'm kind of worried I'm starting to do that. Whenever a friend says they have a cold or anything, I assume it's because they're positive. This is something I'd really like to nip in the bud, and it's probably another projection of my own anxieties about my status onto other people.
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