Sunday, December 15, 2013

2013: My Rebirth - Part IV (Behind Enemy Lines)


That was the longest weekends ever.

It was neither smooth sailing, anxiety have exacerbated things. Yes, I am determined to go to war. Yes, I have reinforcement on the ready. "To, abaton kaw jan ni tatay", sis called to inform us dad will leave the province and come to Manila to pick me up(baw dad). And yes, Chad says there are GI (government issued) ammunition for free if I finally get the score and if it's low enough to warrant it. But that will happen Monday following that long ordeal of chronic anxiety attacks over the weekends.


Although, then I'm starting to know my enemy better as suggested by Sun Tzu in The Art of War. I have read more blogs which led me to more official health websites (like UNWHO, UNAIDS, TheBody). It's like spying on your enemy. The research and readings better equipped me in understanding my current situation. Let's analyze some.


The shortness of breathing(SOB) from respiratory tract infections(RTI), as was diagnosed by the Imus hospital doctor, was caused by either upper respiratory infection common on sinusitis or allergic rhinitis which I know I have, ever since I can count with my fingers(that usually got stuck on my big nose when I was a kid). Mucus or 'sipon' will either clog the air passage through the nose or the throat. Or this SOB could also be caused by lower respiratory infection like pneumonia. In the Philippines, this is just as common as TB. You don't get infected unless your immune system is compromised or you are either too young or just too old and sickly. Pneumonia will make you feel like you can't breathe enough air you are forced to open your mouth and engulf more to get to your lungs. "Parang kulang sa hangin parati", I complained to Inday and Anne. I don't  hyperventilate like on asthma attacks, I never had that(knock on wood), it's just like a feeling of lacking air. Like my lungs want more but can't take much. Makes me feel dizzy really, to a point I'd panic. Anxiety trigger number 1.

The chronic LBM since January is also called wasting syndrome. Gastro intestinal infection are common to immuno compromised patients because there are a good number of pathogens that could infect us through the food we are eating or water we are drinking (e-colli, salmonella, other bacteria and parasites). This is usually caused by improper food handling or spoiled food or dirty raw materials or ingredients. My defecating schedule is very erratic, not regular, but frequent. I'm not lying if I say I have my "colon calling cards" on all restrooms in the office and my "anal autographs" on all Charlie-Romeos of the malls and establishments I have been to(quotes from Dr. Sheldon Cooper). And my colleagues can attest to that, if I say I need to go, I actually meant I'm almost there, delay me by a second and I'm a goner. So back off or you'll mess up with anxiety trigger number 2! *constipated evil grin here*

3rd on my anxiety list is the thrush in my mouth, a fungal infection. Yes, dandruff on your oral cavity if you want to call it that. I wished this will really go away with the medicine the TMC doctor gave me. I've been spending a fortune to no avail on this swishing and swallowing. And it's really uncomfortable when I swallow food that I lose my appetite. Not just that, I have its cousin on my facial hair too. Its flakes as big as "kararaw" (the operating word here is BIG, so go figure). I just use moisturizer on my face to cover the flaking. And that's not even mentioning what's in my semi-kal hair.

So there, somehow i know the front liners of my enemy. I just need to know what will defeat them and just do it. Rest and more fluids for the RTI and SOB. Well cooked dishes, rich in fiber food and more fluids for LBM. Gargle solution, moisturizer and again more fluids for the triple-combo fungal infection. Water is major major in my arsenal, it should be, and not just for PLHIV but all of us who desire to live a healthy and beautiful life.

Now that I know the lieutenants of my enemy, how about the war general himself?

That will require more intelligence, reconnaissance and field work. And I started that Monday. I'm about to find out the casualty at my own barracks, or the survivors left in this "blood" war.

We were up early morning. Although Alabang is just 30 minutes van ride from our place in Cavite, it's our first trip to the facility. And Alabang is not our territory. Not like Pasay or Ortigas where the maps are drawn on my palm. We can't afford to lose our way as Chad warned us to get there by 0700 hours. We cannot be late or else we wait for another day or worse another week. This time, Anne joined us. She doesn't want to be on the receiving end of updates through texting with Inday. The waiting is just more nerve racking for her. Jimmy, our very loyal housemate-turned-OFW, will have to watch over the day's operation of the Sari-Sari Store. So we were all set that morning.



The trip was short, and we got there around 0630 hours, few more minutes and we met Chad near the Alabang Fire Station. We headed for RITM (Research Institute for Tropical Medicine). I met Paul there, my "batchmate" in the satellite clinic the previous Thursday. Needless to say he's a comrade PLHIV, a blood brother, Paul was kind enough to give me an extra face mask before we stepped in. We were joined by two more at the lobby before Chad enrolled us at the admissions desk, we got registered in ARG (AIDS Research Group) too. We proceeded to the labs for our baseline tests; CD4 count, blood chem, sputum and chest X-Ray. We met some other guys for the same routine, some were very quiet, "malayo ang tingin", like war-shocked combatants. But some were loud and having a field day. Probably they're friends outside or acquaintances in ARG. Their optimism were contagious. I was amused, our kind can really put FUN in funeral, no pun intended. Some of these guys were assisted by Chad's friend. I was told they both belong to the Love Yourself volunteer group assisting new PLHIV. We had lunch together. I was the only one with two extra large chaperons, Inday and Anne. The two were comfortable talking to my "batchmates" while eating the specialty dessert at that canteen, buko salad ice candy. I later learned the total number of new PLHIV that month was the highest ever recorded at that time, 415. And I belonged to that group. Crazy, just overwhelming!

The afternoon dragged. More profiling inside the DOTS clinic in the main building; height, weight, BP, temperature, allergies, etc. I met my Infectious Disease (ID) Doctor inside the consultation room, Dr. Wico. He did ask me some questions, very basic like recent medical condition. So I told him about the LBM, the coughing or SOB and the oral thrush. I gave him a rundown of all the medications I have been taking. I showed him some hospital records. He made notes, lots of it. He checked my eyes and my breathing and some "more" doctors usually check in cases like mine. He told me we have to wait for the CD4 test results and will be called to go back later. By the way CD4 T-cell count is an indicator of the strength of a person's immune system. HIV destroys these CD4 T-cells inside the PLHIV's body. This count determines the stage of the HIV progression and predicts the risk of complications. The higher, the better.


We waited in the ARG office downstairs. That's a spacious clinic, complete with aircondition, sofa set and wide-screen TV. More benches outside in the hallway. On later visits I realized there could be more clients visiting in a day. I heard one day last month it peaked to 72 ARG clients, and that's some organizational nightmare!

It was late afternoon when we were called back to DOTS. Everyone was tired and weary. Not much fanfare on the hallways anymore. DOTS head nurse Ms. Ellen was allergic to that hanky-panky, anyway. But that's not the reason why she no longer works there, if you ask me I don't know. We were told the results were in. I went inside the consultation room and before I can even sit down after I locked the door, Dr. Wico said I have to start with the treatment already as my CD4 is low. Hmm some sense of urgency there. He checked the paper again, "and... yes it's 5, quite low". I have to pause there and mentally correct him, maybe he meant very very low. Just 5, F-I-V-E 5! Most of the treatment hubs recommend giving the Antiretroviral drugs as soon as the CD4 drops below 350. Mine was 5 on its first test. Technically, with three known Opportunistic Infections (OI) and a CD4 count way below the cut-off of 200, my case was already considered under the category AIDS(Acquired Immune Deficiency Syndrome). I'm not sure if de facto, my record counted as AIDS case in the official tally of DOH, The AIDS Registry. To me it didn't matter anymore.


Red alert lights flashing before my eyes, I can only hear loud war siren vibrating in my ears. "I am down to my last 5 soldiers!"


to be continued...


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