Newly infected clients.. this week I had three. They are not stupid. They are regular people who got infected with HIV. One seems totally shocked.. This was not what he planned. He is a lawyer. This is not what he thought was going to happen. Two don't seem too upset about it. I get the feeling that they figured it was going to happen.. someday.
All of them understand how HIV is transmitted yet.. they became infected anyway.
Tell me.. why are people not completely afraid of this disease.
HIV is forever. Forever medications, forever infectious. Forever risk of diabetes, heart disease and cancer in addition to the illnesses that are associated with HIV itself. Forever changes to your body that are evident of HIV, that are symbols for HIV infection.
Why is sex so overwhelming that our judgment is no long is present. Where does out common sense go?
I have a young female patient . She is 19. She delivered a baby about three months ago and gave it up for adoption. She came into prenatal care very late to find that she is HIV positive. She took her medications to prevent transmission to the baby.. so far it is negative. She continues to take her meds now. I saw her today and we were talking about her plans. She has no family or real friends. She gets support from a local HIV agency who are very concerned for her but she finds then very rigid and overbearing. I asked her today what she wants to do. This is what she said.. " I want to travel around and play around until I get sick".
This made me so sad. Here is a young woman infected through heterosexual sex. She does not really know when. And now.. what is her life to become. As much as I try to tell her that she can manage this disease and live a very long time.. she just sees illness in her future.
This makes me so sad. She has kind of given up.. although she promised me she would take her medications. She also promised me that she wold come see me every three months for lab work and to let me know how she is doing.
She is a child.. roaming alone with HIV. She is beautiful by the way...
Do I think she will practice safe sex... possibly not.. she has no income, no skill, loves alcohol. A very dangerous combination.
What can we do for her?
What can we do to prevent more hers?
How can we love her but not "lock her in a box"?
Why is it OK for my young gay men to get infected as if it is going to happen anyway.. eventually?
Condoms are free and they are everywhere...
there is needle exchange or ways of cleaning needles to prevent the spread of HIV.
There is no excuse in this country to get infected with HIV.
Help me figure this out.......
what do you think???
Wednesday, October 28, 2009
Friday, October 23, 2009
at first it is hard and then....
Today, my patient Clyde asked me if I had written on my blog latety. I said no and thenI asked if I could write about him. He said yes and I can even use his name. I have know Clyde for several years. He arrived at the clinic in pretty bad shape, filled with denial and filled with rage. Getting infected with HIV was not part of the plan that he had for himself. He is a good ole boy, a man that was married and in with the "in" crowd in his home town. An EMT or maybe a paramedic.. working his way up in life. He married, way too young, his high school sweetheart.. The marriage lasted a bit but then Clyde discovered another way. The way of "the party" and his life took a turn.. it was really fun initially, sex, drugs, experimentation etc..... Well he made his way to California and ended up getting test for HIV at a Planned Parenthood here. He was going just to support his other friends,, those friends who had been messing around,.. too promiscuous. not him...them. And he did have a rash that needed attention.
He certainly tells his story much better than I and fortunately he does all the time as a message of prevention...
well of as you may have expected he tested positive for HIV. This was so not in the plan.. This sent him reeling even further into the party abyss. more sex without disclosure.
He would show up at the clinic not wanting to be there and angry about being there and not at all ready for help. then he would disappear,, get into more trouble and then return with various medical issues...
All along, even though he was completely frustrating there was always something charming about this man. His southern accent and smile... was sweet even when he was completely not.
One day I remember being in an exam room with Clyde and he was in really bad shape and I figured at this point I had nothing to loose so I laid it on the line. I told him that he was going to die of AIDS if he did not stop this crap. I remember telling him that I cared for him and that it was hurting me to see him like this but that if he was not going to participate in getting well then there was nothing that I could do for him so he may as well stop coming in. I think that is pretty much how the conversation went.
I had impact that day and Clyde thanks me every day.. I think through his whole initial journey no one said that they cared, no one said you will die if you do snap out of it and that when you are ready I will help you.
Something changed. Clyde got well. HE got clean .. he got motivated.. he got healthy.
Now I can tell you that Clyde has managed his HIV, he is managing his heart (the one that beats and the one that feels). AND, he is also a positive speaker in the area. He tells his story to anyone who will listen hoping that he can prevent this virus from infecting another soul. He understands, as I do, that this virus will end only when the transmission stops and not until then.
He has taken his situation and created good from it. He is not afraid to love others, to protect others.
Now he comes in, a robust smiling man that has gotten his life back. H rides a bike, he is in school.. he is beautiful.
He would be the first to tell you that the virus sucks but he is stuck with it and has now chosen to control it rather than it controlling him.. He is one of the reasons I go to work. He will save someones life with his story and his power comes from his words, his heart and his love of self and his love of others. He always thanks me for being in his life.... and I want to thank him for being in mine.
Thank you Clyde. May you live many healthy and happy years with laughter in your life.
And FYI, if you read the previous story about my son, i want ed to let you know that he is well and living the life of a freshman at UC Santa Cruz.
He certainly tells his story much better than I and fortunately he does all the time as a message of prevention...
well of as you may have expected he tested positive for HIV. This was so not in the plan.. This sent him reeling even further into the party abyss. more sex without disclosure.
He would show up at the clinic not wanting to be there and angry about being there and not at all ready for help. then he would disappear,, get into more trouble and then return with various medical issues...
All along, even though he was completely frustrating there was always something charming about this man. His southern accent and smile... was sweet even when he was completely not.
One day I remember being in an exam room with Clyde and he was in really bad shape and I figured at this point I had nothing to loose so I laid it on the line. I told him that he was going to die of AIDS if he did not stop this crap. I remember telling him that I cared for him and that it was hurting me to see him like this but that if he was not going to participate in getting well then there was nothing that I could do for him so he may as well stop coming in. I think that is pretty much how the conversation went.
I had impact that day and Clyde thanks me every day.. I think through his whole initial journey no one said that they cared, no one said you will die if you do snap out of it and that when you are ready I will help you.
Something changed. Clyde got well. HE got clean .. he got motivated.. he got healthy.
Now I can tell you that Clyde has managed his HIV, he is managing his heart (the one that beats and the one that feels). AND, he is also a positive speaker in the area. He tells his story to anyone who will listen hoping that he can prevent this virus from infecting another soul. He understands, as I do, that this virus will end only when the transmission stops and not until then.
He has taken his situation and created good from it. He is not afraid to love others, to protect others.
Now he comes in, a robust smiling man that has gotten his life back. H rides a bike, he is in school.. he is beautiful.
He would be the first to tell you that the virus sucks but he is stuck with it and has now chosen to control it rather than it controlling him.. He is one of the reasons I go to work. He will save someones life with his story and his power comes from his words, his heart and his love of self and his love of others. He always thanks me for being in his life.... and I want to thank him for being in mine.
Thank you Clyde. May you live many healthy and happy years with laughter in your life.
And FYI, if you read the previous story about my son, i want ed to let you know that he is well and living the life of a freshman at UC Santa Cruz.
Monday, October 5, 2009
My dear man from Africa
Several weeks ago I told you about my older dear gentleman from Africa. He has multiple medical problems. We have been trying to get him insurance coverage because he needs a hematologist and a nephrologist (blood and kidney). Initially we are able to g et him ADAP (AIDS Drug Assistance Program). This is a state program that ensures that all people with HIV get the antiretroviral medicatons that they need. No matter your financial situation or your immigration status you will get your HIV meds.
When you get ADAP you are eligible for County innsurance (if you do not qualify for medi-cal). So all of our undocumented patient will get the county coverage. If you are here illigally you can get care. Well, my dear man was here on a tourist VISA and because her was "legal" he did not qualify. Becasue of this he has to travel back to his home country for three months and will hopefull get a visa to return. Imagine the care that will be available??????
At the clinic where I work, we have funds to provide care and labs for our clients. But, if a patient like my dear man, needs additional care it is not available.
This is really getting to me. First of all, he will not be able to get appropriate care in his home country. This dear man is very ill and because of insurance and immigration he actually may die from his illness. We have assisted this dear man with getting him enough medications to last for three months t control his HIV. THis is crucial to prevent resistance to his medications. We must also protect his kidneys and won't be able to monitor his labs for the three months that he is gone. I am so afraid for him.
I know that we have lots of feeling about covering non citizens... but this is a human being, a dear sweet man who has been infected by a horrible virus and it seems that as humans it is our responsibility to care for another human being. Bend the rules. Care for this man. In the big scheme of financial spending his needs are minimal.
I will worry for this man every day that he is gone. I will await his return and hope that he survives the madatory hoops that he must jump though. Imagine how his son feels. Imagine if this was your father. The whole situation breaks my heart.
Keep this dear man in your heart. I will let you know when he return. Hopefully he will.
When you get ADAP you are eligible for County innsurance (if you do not qualify for medi-cal). So all of our undocumented patient will get the county coverage. If you are here illigally you can get care. Well, my dear man was here on a tourist VISA and because her was "legal" he did not qualify. Becasue of this he has to travel back to his home country for three months and will hopefull get a visa to return. Imagine the care that will be available??????
At the clinic where I work, we have funds to provide care and labs for our clients. But, if a patient like my dear man, needs additional care it is not available.
This is really getting to me. First of all, he will not be able to get appropriate care in his home country. This dear man is very ill and because of insurance and immigration he actually may die from his illness. We have assisted this dear man with getting him enough medications to last for three months t control his HIV. THis is crucial to prevent resistance to his medications. We must also protect his kidneys and won't be able to monitor his labs for the three months that he is gone. I am so afraid for him.
I know that we have lots of feeling about covering non citizens... but this is a human being, a dear sweet man who has been infected by a horrible virus and it seems that as humans it is our responsibility to care for another human being. Bend the rules. Care for this man. In the big scheme of financial spending his needs are minimal.
I will worry for this man every day that he is gone. I will await his return and hope that he survives the madatory hoops that he must jump though. Imagine how his son feels. Imagine if this was your father. The whole situation breaks my heart.
Keep this dear man in your heart. I will let you know when he return. Hopefully he will.
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