Wednesday, November 09, 2005

And Now, Some Fresh Numbers

Monday found me at the doctor for the results of my latest blood work. Before I get to that, I need to vent a bit. Overall, considering I have no insurance and am essentially a ward of the state, my access to and experiences with health care for HIV+ persons has been excellent. I've been extremely blessed in that regard. I am able to secure appointments easily and quickly. My therapist, adherence counselor and my doctor have all provided me with direct phone numbers in order to reach them should a crisis arise. During the course of my previously chronicled emotional meltdown, I was afforded comfort and concern, as well as provided more intense psychiactric counseling, and for the most part, felt a sense that I had people looking out for me.

Having said that, this past two days has been an exercise in frustration. My Monday appointment was for 2:30. I freely admit I have a tendency to dawdle in the afternoon, and leave at the last possible minute (if not a few minutes late) for the 1/2 hour trek directly across town to the Health Center. I don't expect to breeze in and be swept directly into the exam room. I'm willing to wait, and I understand that seeing patients can be inexact as far as budgeting time. 15, 20 minutes, even 1/2 hour and I don't really take note. But when a nurse comes in to the waiting room and blithely informs everyone that the doctor is approximately an hour and twenty minutes behind on his appointments well, that's just poor management and a bit of an insult to patients who have a limited amount of free time. Indeed, it was a full two hours later that I finally found myself in an exam room, still waiting to actually see my doctor. By the time he arrived I was starving and completely uninterested in anything but a rudimentary exchange of information. I got my numbers, picked up some renewed prescriptions and told him I was feeling "Better. Fine." To top it all off, half the reason I was there was because I wanted to get a flu shot. Imagine how through I was when he informed me they were "out" and I should contact the city Health Department or call and come back later in the week when they "might have more." Another opportunity to sit around and possibly (or not) get a flu shot? Great! Can't wait!

The next day found me at my local Duane Reade, armed with three prescriptions, two of which were renewals. One of them, Androgel, I've been taking for months. So imagine my surprise when the "pharmacist" informed me that he couldn't fill my prescription. Because I needed a prescription. Seriously. I immediately started talking to him like he was brain damaged.

"You do realize that you're holding a prescription don't you?"

"But you need a new one."

"Newer than 24 hours ago?"

"When did you get this?"

"Yesterday. It's a prescription from my doctor. I'm not sure what you mean. It's the only prescription I've ever had."

"Well, we don't have it so we'll have to order it. It will be a while."

"How long is 'a while'?"

"Probably Friday."

"Fine."

"What's your date of birth?"

"Fuck you." (I made that part up.)

"It will be ready tomorrow."

(Huh?) It wasn't lost on me that Friday had now become tomorrow. But I had an appointment with my therapist and decided to leave well enough alone. It was two hours later when I returned to the pharmacy. Would you be shocked to learn that the Androgel prescription was, in fact, filled that day? He out and out lied about not having it. Sure enough though, another prescription I had filled at that same pharmacy 3 weeks earlier was kicked out as "not covered". I have since learned that for once, they got it right, sort of. As it turns out, the state will cover my medication in a stronger dose, and not the weaker one I had requested. More medication than you need? Yeah, we'll pay for that! Again, I'm just venting, but I've been spending a lot of my free time lately taking care of my physical and mental health. It's exasperating to have to keep returning to places two and three times to get anything done.

Enough. I promised you some test results.

After about 8 weeks in treatment my viral load has dropped again. From 7,900 to 1,163. My T-Cells are a robust 452. Equally as important, my liver is showing no adverse effects from the medication, and my cholesterol, both good and bad, are unchanged and beyond excellent. Oh, I am slightly anemic. But that runs in my family and it shows up periodically in my tests.

Considering it took almost two and a half hours, I guess I could get worse news than I'm just fine.

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