Monday, February 4, 2008

Good News Comes With a Warning From the Surgeon General

Today’s blog entry began as a message to a good friend of mine on myspace. (Several of you fall into that category. ;-)

I had received some wonderful news last week but have been holding off on talking about it because… Well, I needed to verify the news. It was a bit “too” good to believe confirmation in the form of a re-test. (It has to do with my health; when you get to be an old fart of 44 it’s always your health that you find yourself talking about … well, most of the time!) That and, if you’re gay, all the cute guys that [still] catch your eye (regardless of whether you catch theirs or not). {grins}

So… the confirmation has been made and while the news is not [quite] as astonishing as it initially seemed, it’s still astounding!

As friends will recall, I’m HIV-positive. My ex infected me with the virus some years back unbeknownst to me. I discovered this two days after I left my partner (in early March of 2001). For now, we won’t dredge up all of the feelings of anger and betrayal I felt during those first days.

While I am very angry with my ex for his part in all of this, the bottom line is it takes two to tango. He did lie about his status but I should have taken matters into my own hands and insisted on real proof in the form of test results (when we FIRST met!) … I didn’t. Whadda’ ya gonna do? Part of this blog entry will take the form of “advice to my friends/readers” — so if you don’t like advice, “change the channel NOW!”

So, here begins the Story…

I was diagnosed as HIV-positive in March of 2001; I found out two days after my 38th birthday (which coincidentally was the day I left that sorry asshole ex of mine). I had gone in to be tested because I was confident I was HIV-negative and just wanted confirmation of this; a bit of expected “good” news in the face of all the shit I was and would be facing now that I’d finally made my break from an abusive relationship (6.5 years of abuse, I might add). Instead of good news, the news I received that Wednesday was … well, quite the opposite. (I remember those two hours vividly, as well as my reaction to Greg (my ex) when I first heard he had been trying to reach me. I called him back; you don’t really want to know what I had to say to him during that conversation – trust me!

(I remember his first words in response to the news that I had just received… Never mind, I’m rambling for the moment. Let’s get to the point of this entry. If I allow myself to get side-tracked into a long discussion surrounding my ex; well, I just wouldn’t get to the real point of today’s blog entry if that’s allowed to take place.)

My friends know I’m HIV-positive; I don’t keep it a secret. It’s not something I always talk about (because doing so reminds me of what a lousy judge of character I have been in the past – and of my own sense of failure in making good, sound judgment calls that could have prevented this story from occurring in the first place). So, I discovered I was/am HIV-positive and because of that my immune system would, as time progressed, become suppressed. I would come to be diagnosed with Non-Hodgkin’s Lymphoma in late 2006. The cancer, in this case, falls into the category of “an opportunistic infection.”

My battle with cancer was well-fought and bore favorable results. I went through chemotherapy and am now in remission, having been so since late February of 2007. However, even that is not what this entry is about.

When they diagnosed me with Non-Hodgkin’s Lymphoma, the doctors recommended I go on meds for the HIV. I was NOT happy about this but my t-cell (CD4) count was far too low and the doctor knew the oncologist would like order a number of rounds of chemotherapy for treatment of the cancer. Such a treatment would likely suppress my immune system further.

For those who are not well-versed on immune systems, I’ll provide you with a short lesson. Your immune system is comprised of cells that fight off infections. Those cells are called “t-cells” (commonly referred to as CD4). A healthy, non-infected person’s CD4 count can be anywhere between 1200 and 2000 (or more). Once infected with the [HIV] virus, however, your CD4 count is suppressed. Thus, your immune system and its ability to fight off infections is suppressed/hampered. My understanding is the number of CD4 cells in your system is slowly lessened/depleted because the virus makes it difficult for such cells to multiply (and the existing cells have a finite life span, so they eventually die off). As your CD4 count falls lower and lower, you become more and more susceptible to opportunistic infections.

Once diagnosed as HIV-positive, it is imperative you be tested regularly to see what kind of shape your immune system is in. Two factors are most important; the number of copies of CD4 cells (the GOOD cells) in your system and your viral load (percentage of BAD/infected cells). Basically, your viral load is the number of copies of HIV in your system. So long as your CD4 count is high and your viral load is low, you’re in good shape. If however, your viral load goes up and your CD4 count goes down – this means your immune system is basically getting worse and you may well be facing some important decisions regarding your health at some future point in time. When I was diagnosed with the cancer, my viral load was VERY HIGH and the number of copies of CD4 cells in my system had fallen to below 300. This is why my doctor recommended I go on meds.

As it turned out, it wasn’t the diagnosis of cancer that had me most upset. What was most upsetting was being told I needed to start a regimen of meds to boost my immune system. I remember the thoughts racing around in the back of my mind, at that time, were that “this was the beginning of the end.” (That wasn’t the case – but it was what I was thinking at the time – and it had nothing to do with the cancer.)

The good news is the medicines HAVE been doing their job and the further out I get from having had chemotherapy (which “beats down” the number of copies of CD4 cells in your system), the more rapidly my immune system shows signs of improving (see table below).

Date: CD4 Viral
297   173,733 First diagnosed w/cancer;
viral load is extremely high.
291 5,102 Undergoing
chemotherapy for the cancer; drop in viral load is a result of the HIV
219   <
continues to cause my CD4 count to drop while HIV meds lower the viral
load (and provide support to immune system, preventing it from dropping
more rapidly).
256 <
completed. Viral load holds steady at less than 400 copies while HIV
meds boost my CD4 count by 37 copies.
302   <
distance is put between last chemotherapy session; meds continue to
boost CD4 count and suppress viral load to less than 50 copies.
count drastically improves, improving by an increase of
204 copies; viral load holds steady at less than 50.

Some may ask, “Why are you putting all of this out there for the world to see?” I’ve considered keeping it private but my problem is that FAR TOO MANY people believe HIV is no longer a real issue. I hear about the numbers of cases increasing in the straight community as well as with younger adults. Far too many believe they are not at risk. Everybody who is having sex and is uncertain of their partners HIV-status “is at risk” of being infected! I can’t stress that enough. I’m not saying “abstain from sex.” Hell, even I have a difficult time saying no to my hand …. she’s a great lover! (Okay, bad joke …. sorry.) I’m just saying “be aware!” Don’t take unnecessary chances with your health. Some of you reading this are dear and near to my heart. Some of you, on myspace, are like sons to me so as your “papa” don’t ass-u-me that the person you are sleeping with is “negative!” They may have become infected and simply don’t know – or they may be lying about their status. {sigh}

I told a young friend of mine on myspace earlier today that before you even consider having sex without a condom – make certain that: (1) You are in committed, MONOGAMOUS relationship and (2) both you and your partner have not been infected (get tested (twice, once now and again in six weeks). Then and ONLY then can you even consider having sex with your partner without a condom.

I know— We all want to believe the best about those whom we fall in love with but please insist on seeing test results which clearly indicate your partner is HIV negative before you even consider having unprotected sex. I know I sound like a harping old father (wish that I were) but I’d like to know my young friends are being careful and not taking unnecessary risks. I often send my hugs to you and I tell you I love you often enough but perhaps I’ve fallen a little short on impressing upon you the importance of not taking this particular risk (regarding HIV). I’d like to know you’ll be around for many years to come, enjoying life at its fullest and NOT having to be concerned about an immune system which isn’t performing fully.

At present, a diagnosis of HIV-positive cannot be reversed – it’s my hope that you NEVER have to worry about all of the ‘what ifs’ which come along with a diagnosis of being HIV-positive. A diagnosis of “positive” isn’t the death sentence it used to be — but being “negative” damn sure beats being positive, hands down! Please be careful.

Sorry for the lengthy entry but I wanted friends to know I’m doing much better, health-wise. I also wanted to impress upon you the importance of using good sense while still following your heart. Don’t let your guard down only to repeat my own mistakes for I did not wish to “rock the boat” (with my partner) and the consequences of that is I must live with being HIV-positive for the rest of my life. If such is not your circumstance at present – don’t make it so.

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