Category: Treatment


Goodbye San Lazaro H4!

Finally, I got myself transferred to Makati Medical Center as my new treatment hub. Although it’ll be quite expensive unlike at H4 where everything’s free, it’s much more convenient and comfortable. 😀

Goodbye to once-a-week OPD days; bitchy doctors, nurses, and staff; waking up early to find out that I’m already 20th in line; and exposure to unwanted elements.

With my initial consultation with Dra. G at MMC, she recommended that I do the following:

1. retake my CBC count. My hemoglobin count decreased to below normal. If it stays the same, I might need to stop taking zidovudine and take something else instead

2. take the following tests:
a. blood chemistry. It’s been almost a year since my blood chem
b. viral load. Dra G got puzzled why the doctors at San Lazaro never recommended me to get my baseline viral load count
c. vaccines – tetanus, pneumonia, flu

Since I need to travel out of the country for training for three months, I was able to get hold of three bottles of my ARV treatment medications (they charge PHP 100.00 per bottle for storage fee through) unlike at H4 where it’s a tremendous challenge to get hold of more than a month’s supply of ARV medication even with valid reasons.

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CD4 count – 11/12

It’s been quite a while since my last blog post. Been quite busy recently with lotsa stuff. Just a brief update on my treatment, my CD4 count rose to 251 after more than a year on ARVs. The doctors at San Lazaro H4 says that I’m responding well to my treatment. Though for me, I’m still not quite content with this count. Gotta push with healthy living. I need to stop smoking hoping to boost my count further up.

That’s it for now!

CD4 Count

It’s took me 3 weeks since my blood sample was extracted for CD4 count to pay H4 a visit to claim the result (and at the same time refill my AZT+3ZT and EFV supply). I was partial happy and disappointed with my most recent count after being on my ARV treatment since October 2011:

May 2010 – 424
February 2011 – 366
August 2011 – 97
May 2012 – 198

There you go. 198. up by 101 from more than six months ago. I’m happy that it went up as it’s a sign that the medication is working. I’m quite disappointed though that my CD4 count didn’t go up as I’ve expected. My lifestyle is to be blamed for this. I haven’t cut down on my smoking and have started consuming alcohol. Wasn’t even taking multivitamins as my doctors prescribe. Although I get ample rest (8-10 hours per day), my sleeping pattern is still incorrect staying up until the wee-morning hours for the sake of going out on dates or chilling out with my friends. I now resolve to correct these unhealthy habits and work on improving my health.

Dra. A is quite happy that the medication is working for me. She explained during my consultation that the count actually varies on a person to person basis and depending on our lifestyle. She reiterated that I need to work on targeting having more than 1,000+ CD4 count. Given that my count is still below 200, she prescribed that I take cotrimoxazole as prophylaxis against pneumonia M-W-F until my count surpasses the borderline level of 350.  She also reminded me to have pneumonia shots every six months and get annual flu vaccination.

After weeks of procrastinating, I was finally able to drop by the hospital nearby our village to get my blood extracted for my blood chemistry. It is a routine procedure at H4 to have this data presented to the doctor on duty every six months to check how the body is reacting to the ARV medication. Usually, the doctors prescribe this upon scheduling the patient for his or her CD4 count blood extraction. I’m quite glad that the result is normal despite the fact that I only had 5 hours of fasting instead of the required 8 hours. By fasting, there should be no food nor liquid intake in the prescribed duration.

Below is the result of my blood chemistry. Normal values as encapsulated within brackets for everyone’s reference.

FBS: 4.65 [3.89 – 5.83 mmol/L]
Urea Nitrogen: 15.20 [10 – 50 mg/dL]
Creatinine: 0.71 [0.4 – 1.4]
Cholesterol: 6.52 [< 5.171 mmol/L]
Triglycerides: 1.07 [up to 2.88 mmol/L]
SGOT: 20.68 [40 u/L]
SGPT: 24.06 [41 u/L]

Hemoglobin: 139 [130 – 180 G/L]
Hamatocrit: 0.41 [0.40 – 0.54 L]
RBC: 4.4 [ 4.5 – 6×10^12 L]
WBC: 8.8 [ 5.0 – 10.0×10^9 L]
Neutrophils: 0.60 [0.040 – 0.75]
Lymphocytes: 0.39 [0.20 – 0/45]
Eosinophils: 0.01 [0.01 – 0.06]

Almost two months ago, I finally got my 3rd CD4 count — 97. Officially, I have full-blown AIDS. I have started my medication a week ago and will be posting the details of the recent incidents in the upcoming days.

2nd CD4 count…

I finally got my CD4 count result this afternoon after almost a year. From 424 baseline, my count dropped to 366. Not bad given the mere reduction of 56 despite my stress level. In fact, I can consider myself lucky. Other people loose 200 in three to six months. I guess having a positive outlook in life and being a happy person helped a lot.

I also got my HCV and RPR results. Both are non-reactive. Yay!

Dra. D advised me to go back to H4 next week to consult with Dra. A if I need to start taking ARV medication or not. If I were to choose, I’d rather not take any medications yet until it’s needed.

Blood Chemistry

It’s been almost a year since my last consultation at H4. When I got back to the Philippines from my vacation, I prioritized my check-up. I went to H4 to have myself scheduled for my second CD4 count. Dra. A scheduled me for February 17 and then gave a prescription to have my blood chemistry tested.

I had my blood extracted this morning in a hospital in QC and I got the result before I went home from work. The results are still normal based on the normal values. But there’s a slight deviation from my baseline. I have yet to get my dad’s opinion on this.

Now Baseline
FBS 4.56 4.78
Urea Nitrogen 14.9 7.8
Creatinine 0.9 0.86
Uric Acid 5.96
Cholesterol 4.51
Triglycerides 0.69
SGOT 31.9 23.6
SGPT 28.6 35.9

I will have to visit H4 on Thursday to get my CD4 count result. I’m hoping that the count won’t be too low. I don’t want to take ARV medication yet.

Here’s a little primer (with links) on what the blood chemistry tests are for:

FBS
A fasting blood sugar (FBS) level is one of the tests used to diagnose diabetes mellitus (another being the oral glucose tolerance test). In a person with symptoms of osmotic diuresis and an elevated fasting blood sugar level, the diagnosis of diabetes mellitus is usually made.

According to the 2005 Recommendation of the ADA, you may interpret your fasting blood sugar as follows:
FBS < 100 mg/dl (5.6 mmol/l) = normal fasting blood sugar;
FBS 100–125 mg/dl (5.6–6.9 mmol/l) = IFG (impaired fasting glucose);
FBS ≥ 126 mg/dl (7.0 mmol/l) = provisional diagnosis of diabetes

Urea Nitrogen
A BUN test is done to see how well your kidneys  are working. If your kidneys are not able to remove urea from the blood normally, your BUN level rises. Heart failure, dehydration, or a diet high in protein can also make your BUN level higher. Liver disease or damage can lower your BUN level. A low BUN level can occur normally in the second or third trimester of pregnancy.

Creatinine
Creatinine and creatinine clearance tests measure the level of the waste product creatinine in your blood and urine. These tests tell how well your kidneys are working. The substance creatine is formed when food is changed into energy through a process called metabolism. Creatine is broken down into another substance called creatinine, which is taken out of your blood by the kidneys and then passed out of your body in urine. See a picture of the kidneys .
Creatinine is made at a steady rate and is not affected by diet or by normal physical activities. If your kidneys are damaged and cannot work normally, the amount of creatinine in your urine goes down while its level in your blood goes up.

Uric Acid
The blood uric acid test measures the amount of uric acid in a blood sample. Uric acid is produced from the natural breakdown of your body’s cells and from the foods you eat.

Most of the uric acid is filtered out by the kidneys and passes out of the body in urine. A small amount passes out of the body in stool. But if too much uric acid is being produced or if the kidneys are not able to remove it from the blood normally, the level of uric acid in the blood increases.
High levels of uric acid in the blood can cause solid crystals to form within joints. This causes a painful condition called gout. If gout remains untreated, these uric acid crystals can build up in the joints and nearby tissues, forming hard lumpy deposits called tophi. High levels of uric acid may also cause kidney stones or kidney failure.

Cholesterol / Triglycerides
Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.

SGOT / SGPT
An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes (proteins) in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured for any reason, these enzymes are spilled into the blood stream. Enzymes are proteins that are present throughout the body, each with a unique function. Enzymes help to speed up (catalyze) routine and necessary chemical reactions in the body.

Among the most sensitive and widely used liver enzymes are the aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes are normally contained within liver cells. If the liver is injured or damaged, the liver cells spill these enzymes into the blood, raising the enzyme levels in the blood and signaling the liver disease.

GENEVA, 5 October 2010––UNAIDS welcomes commitments made by donors at the Global Fund to fight AIDS, Tuberculosis, and Malaria’s replenishment conference in New York, which was chaired this year by United Nations Secretary-General Ban Ki-moon.

The United States of America led the donations—pledging the largest ever financial commitment to the Global Fund, US$ 4 billion over three years––a 38% increase over the preceding three year period. More than 40 countries, including countries with emerging economies, private foundations and corporations committed more than US$ 11.7 billion for the next three years to fund health programmes for the three diseases.

“These pledges come at a critical time. We are just starting to see returns on investments with new infections coming down in most high-burden countries and more people than ever on antiretroviral treatment,” said Michel Sidibé, Executive Director of UNAIDS. “This is a significant and necessary first milestone, but insufficient to meet aspirations. Public and private donors must continue to mobilize resources in order to secure future progress in the AIDS response.”

Despite the record pledges to the Global Fund there is still an overall funding shortfall for the AIDS response. For the first time in 15 years, overall AIDS funding has flat lined. This raises serious concerns on future progress as a slowing in investments will negatively impact the AIDS response.

It is estimated that nearly 2.8 million people are accessing treatment through financing provided by the Global Fund, more than half of the people on treatment today. However there are nearly 10 million people living with HIV who urgently need treatment. Five people are newly infected with HIV for every two people who start treatment.

Large scale investments in the AIDS response have produced encouraging results. At the MDG summit in New York two weeks ago, UNAIDS revealed new data showing that HIV infections have declined by more than 25% in 22 countries most affected by AIDS in sub-Saharan Africa; and with nearly 5.2 million people on antiretroviral therapy, AIDS related deaths have fallen.

Source: http://unaidstoday.org/

Now it’s Acid Reflux…

Great. Now I’m having acid reflux. I’m having chest pains while drinking or while swallowing what I’m eating. I also keep on burping once in a while. When will the pain go away? Have already taken my initial dose of antacid and it kinda minimized the pain. But It’s still there… *sigh*

I have been out of circulation in the past few weeks. Busy with work, buffing up myself, and with socials that I forgot my limitations and the fact that I’m a pozzie. My body had finally succumbed to my weak immunity. I was down with the flu that started up as a bacterial inflammation of my tonsils. The past four days was an eye-opener for me. Ages ago, a simple tonsilitis won’t even develop into a more serious disease. In fact, bed rest and fluid intake would simply serve as cure. But now, a simple disease leads to further complications with extreme adverse effects. My dad even gave me a much more potent antibiotic as the one I’ve been taking before isn’t doing me any good anymore.

After 3 days of bed rest, I’ll be able to report back to work tomorrow. I have to refrain from straining myself from work and other physical activities until I have fully recovered. This three-day bed rest has been very beneficial to me as I was able to invigorate myself and retreat from the daily routine stressful activities. When I looked at myself in the mirror this morning, Although It seemed that I lost a few pounds, I look well-rested and fresher.

I have to regularly remind myself that I am no longer my old self. I’m getting older and my immunity getting weaker. I don’t want to start taking my ARV medication yet. I have to keep my CD4 high. Thus, I really need to take good care of myself.