Tag Archive: San Lazaro


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.

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.

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.

some kind of a good news…

Got a SMS from my ex, King, this morning. He already got his baseline CD4 count from H4 — 586. Yey!

Here’s a map on where the H4 pavillion and SACCL are at the San Lazaro compound which I took when I got my CD4 count. I got lost the very first time I went there and I don’t want my fellow pozzies to be in the same situation that I was in — lost at the TB ward. LOL.

I don’t where exactly is Quiricada street. Usually, I park at the DOH compound in front of the NEC building (LRT entrance) and then I just take a short walk to H4 or SACCL.

my CD4 count…

Finally, I was able to wake up early this morning to go to San Lazaro for my post-laboratory test consultation and to get my CD4 count — my first official OPD day experience. I got at H4 pavillion at around 8am and to my surprise, I was almost the 20th patient in line. The nurse requested for my screen name and patient number for enlistment and then proceeded with the routine monitoring stuff — body weight, body temperature, blood pressure, and pulse rate. After which, I had nothing to do but wait until my name is called. Luckily, the head medical technician from SACCL was invited by the Head doctor to orient people on what CD4 and Viral load testing is all about and their cost implications. A little distraction from boredom. In the middle of her spiel, the nursing assistant called me in to the consultation room.

I handed over my laboratory results to the doctor in charge. After quickly browsing through the figures, she smiled at me and told me that it’s nice that everything’s normal except for the UTI. She wrote me a prescription for ciprofloxacin for my medication and then told me to present her prescription to the nurse at the reception to get my free meds for five days. She handed me another prescription for urinalysis that I need to take once I have completed my medication and told me to drink plenty of fluids, in particular, water.

After our short discussion, the doctor finally handed me the paper containing the result of my CD4 count taken two weeks ago. And to my surprise, it’s just a little below normal — 424. The normal CD4 count of HIV-negative people ranges between 500 and 1600. She told me not to be complacent of my health given that I know that my CD4 count is still high. It’s quite a relief. I left DOH smiling and promising to myself that I won’t risk my health anymore with the my unhealthy lifestyle. Which translates to no more smoking, drinking, stress and sleep deprivation. I need to maintain my CD4 count at that level.

procrastinating…

I’m supposed to go back to H4 this morning to get my CD4 count test result and have a consultation with Dr. A regarding my blood chemistry, and other laboratory test results. But I found it so hard to get out of bed this morning. I opted to take a few more hours of sleep than being an OPD patient in the H4 pavillion in this hellish weather. I swear to myself that next week, I will be there for my consultation. I need to know my CD4 count ASAP. No more delays and attack of katamaran. Besides, I need to get a presciption for the medication of my Urinary tract infection. Though we have a doctor in the family, I need to know which medication to take given that I can’t risk taking drugs that could have adverse effect on my health that could possibly give the virus a higher level of resistance. I haven’t gotten the list of meds that I am allowed to take and the list that I have to avoid. Better be safe the sorry. So next week…

Vials for my blood extraction

As scheduled, I went to SACCL early this morning to have my blood extracted for my CD4 count. It kinda pissed me off that people don’t adhere to the processes and policies including the medical arm itself. OPD time is between 8am and 4pm. I got there early fifteen minutes ahead of schedule and was second in line. As usual, being a government leg, the doctor came in fashionably late. She started handling out our CD4 extraction request forms for data verification and confirmation. And when our names were called out, I was surprised that the queue was not observed. I was served fourth to the last wherein fact I’m second in line. Kinda irritating that being early went in vain. Oh well, at least the actual blood extraction was a breeze. Will be coming back to H4 next week for the results and consultation.

From SACCL, I went to the private hospital nearby our home for the prescribed lab tests to identify opportunistic infections possibly residing in my body. I wasn’t able to make it to the cutoff of 10am for some of the lab tests and I ended up just having my chest xray and urinalysis taken. Will have to go back to the hospital before 10am tomorrow for the rest of the test. Lab tests are kinda expensive as the cumulative amount sums to almost PHP 4,000. Funny think that the nurse there doesn’t know how to add and that the cashier doesn’t verify the charge slip before cashing in. Urinalysis costs PHP 177 while CXR costs PHP 300. I just noticed when I got home that the total amount in the charge slip is 377. The cashier overlooked that! Cool! I got PHP 100 off in my lab tests this morning.

I was endorsed by the DOH NEC officer in charge to the Dr. A for further counselling and medical guidace last Monday. As an eager beaver, I went to San Lazaro Hospital ahead of time. The path from DOH to H4 pavillion is quite a maze. I initially ended up at SACCL thinking that it’s the H4 pavillion.

I bumped into my ex at SACCL. It was also the day when he’ll get his lab result. We talked a bit while he’s waiting for his appointment with his doctor. When he got out, one of my worst fears have become a reality — he’s tested positive. I was apologetic to him but there’s nothing more that we can do but support each other.

When it’s my turn to talk to the doctor, I was informed that I was at the wrong building. H4 pavillion is another maze away from SACCL. I bid my ex and his friend goodbye as I had to hurry as I might miss my appointment. The doctor gave me vague directions how to get there and I ended up at the place where I should be at — the TB ward. I asked the manong janitor where H4 is and he gladly pointed the ill-maintained bungalow-type infrastructure nearby the TB ward.

Given that it’s my first time to be a patient at H4, the nurse got my vital statistics — weight, body temperature, etc. and then endorsed me to Dr. A. Had to wait for a few minutes as Dr. A is still counselling another patient (a cute guy actually. hehe). While waiting, other patients currently confined are discussing their current health status and the ARVs they’re currently taking. I hate to eavesdrop but I had no choice. Fear got the best of me that soon, I’ll be undergoing the same treatment that they’re currently taking and experience the side effects of the drugs once I need to start taking ARV medication.

When came my turn, Dr. A gave me a brief run through of what HIV is all about, what it is not, and the things that I should change in my current lifestyle. As a first timer, she had me fill-up a record form and then asked me for my preferred codename — It’s Fred. She also gave me my reference number — H4 2010 XX which will I use in all my H4 transactions. She also gave me a prescription of the set of lab tests that I need to take to identify opportunistic infections dormant in my body and scheduled me for my CD4 count blood extraction on April 29. I’ll also be scheduled for an appointment with their psychologist to aid me in letting go of the things that I need to let go.

Well, I’ll be back on Thursday next week. Hopefully, I’ll not be lost again. Given that Thursday is San Lazaro’s OPD day, hopefully, I’ll be able to meet a new set of friends — fellow Filipinos infected with the HIV virus

the verdict

I am positive.

No wonder it took so long for my result to come out. The confirmatory result from San Lazaro indicates that I am reactive to HIV 1. I have been preparing for this with the mentality that I am positive until proven negative. and it helped. The OIC accredited by DOH to give the post-testing counselling session was kinda surprised that I took the result well and applauded me for being strong and intelligent about it (the fact that I know a lot about the disease. Well, I did tons of research about it). She had me sent to their general practitioner to have the endorsement form filled up. After the quick physical exam and some questions, my case is classified as clinically stage two. After the physical, I was told that they’ll text me again once they have already endorsed me to San Lazaro for the census, and lab tests (CD4, Viral load, Opportunistic Diseases, et al).

It’s not the end of the world for me. I’m taking this as another chapter of my life. A new page unfolds and it depends on me how I’m going to write the remaining pages of my life. I have to be positive about it as life goes on.

I took the day off from work after finding out the result. Spent the day with my best friend in Trinoma to talk about my plans, what to do next, and when to tell my parents about it. To somehow distract me from the bitter reality, we had lunch, did some window shopping, watched How to train a Dragon in 3D, and had a few bottles with a kabarda. At the end of the day, I fell asleep with the question, “What’s next?”

I am positive and I WILL BE POSITIVE ABOUT IT.