Thursday, April 28, 2005

The View From On The Fence

Coincidentally, I got some fresh numbers yesterday. I got to meet my new doctor as well. This is my third since I started taking rides on the HIV carousel. They seem to stick around for a year or so before moving on. We don't get much of a choice as to who provides treatment. Although I'm sure if I really couldn't stand someone I would be able to switch off. That hasn't happened yet. All of the people I have encountered along the way, from nurses to vampires to health practitioners to doctors and voodoo priestesses have seemed competent, pleasant if not always friendly, and well-informed. From the horror stories I've been hearing from people in other states, (I'm talking to you, South Carolina!) I've been extremely lucky.

On to the results. On the surface, things are good. Cholesterol, liver function and all the incidentals check out fine. My testosterone levels, which were through the roof when I began the therapy to raise it, have leveled off. I no longer throw a bone while watching the laundry spin. Curiously, I've been semi-hard off and on since I woke up today. I have no idea why.

My T-cell count clocked in this time at 407. Down slightly from February (449). My new doctor says that's not significant. Indeed, I tested below 400 in November of last year. Three months later they were back up. What is noteworthy however is my viral load. It's spiking. My test from November came in at around 41,000. By February it jumped to 170,00. I re-tested then and came in around 83,000. April's test and I'm back around 168,00. I'm not alarmed by this nor is my doctor. In some ways I've been abnormal to date, and a certain amount of viral load spiking is actually par for the course. However the newest treatment guidelines recommend beginning treatment if the patient's viral load remains above 100,00. Maybe. Provided there's also a demonstrable drop in T-cell count as well. In theory, if my viral load count remains high, eventually I will see a drop in my T-cells, as the virus eats away another chunk of my immune system. Significantly, I had a cold or cold symptoms more often than not all winter. It's only lately I've been "feeling fine" for an extended period. So it's possible that's why my numbers have been wonky. The other possibility is my illness is making me ill.

So all we've decided thus far, is a re-test that can wait until late June. No chance I'll be keeling over from anything before that. I'm thinking that if I get similar viral load and T-cell counts as this time, since I feel just fine I would opt for waiting to begin treatment. I think it's time though, that I made peace with the idea that treatment is in the offing.

As an hilarious (to me) aside, my doctor has urged me to get my first anal pap smear. I couldn't be more excited. I haven't had it done yet. Apparently, there's an anal pap specialist I need to see. I wonder if he enters the building through the back door? Nyuck, nyuck, nyuck. I slay me.

Hey, maybe now is a good time to sponsor me in this year's 20th Anniversary AIDS walk. It's possible I will be availing myself of more comprehensive services sooner rather than later.

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