Tuesday, 16 October 2012

Living By Numbers


A month after I got my confirmatory result, I finally decided to go to my chosen treatment hub, Philippine General Hospital (PGH) in Ermita, Manila. It was for me the most accessible among the government-owned hubs in Metro Manila. The other hubs are San Lazaro Hospital in Sta. Cruz, Manila and Research Institute for Tropical Medicine in Alabang, Muntinlupa.

On the first Thursday of November, I asked C to go with me to PGH. We met around 9am at Robinson's Midtown. It's just at the back of PGH. We walked to PGH without knowing where to go. We entered the main lobby and found ourselves in the middle of hundreds of people. There was a very long line to get a pink/blue card. Another line was found on the second floor admissions. Then more people are coming in and out of the lobby. Some of them have been there for hours already waiting their turn to be served.

We looked for the directory and didn't find where the HIV clinic is. We asked the lady in the reception and she gave us directions (And I guess it's the wrong one). We spent the next 30 minutes walking thru the corridors of the hospital looking for the clinic. After getting lost in the hospital maze and seeing helpless patients, we gave up. We decided to return to the mall, rest and hang out there. I thought that it'll be easy to find. Lesson learned for me, research and ask first before going.

The following day, I went with a friend who tested positive and was scheduled to go back to Manila Social Hygiene Clinic for his confirmatory result. The clinic is a very old post-war or maybe prewar building. When we got to the clinic, we sat on the long wooden bench and an attendant asked us what we need. My friend said that he will just get his confirmatory result. He was assisted inside the doctor's room and I waited outside sitting on the bench.

As I wait, I saw that there were posters on the wall, basics of HIV, pictures of different STIs, artworks to remember World AIDS Day, and posters on HIV prevention and testing programs. I just read and looked at them. I freaked out when I saw the STI pictures. There's this picture of a vagina and anus with warts all over and penis with pus coming out among others. I just stopped looking because I'm starting to feel like vomiting. I sat on the bench again and waited fro my friend.

After about 10 minutes, my friend came out. He just said "Yun na (That's it)."

He was very calm. Maybe that's really how it goes. Like me, I was very calm when I walked out of ASP office and when I was alone, that's the time I cried.

Since we were already there, we both decided to go to San Lazaro Hospital. It's just across the hygiene clinic. It's not as crowded as compared to PGH. We walked to a small driveway at the back of the hospital to H4 Pavilion. It's where they receive HIV patients. It's easier to find.

When we got to H4, I was surprised. There were just about 10 people lined up to have a check-up. And air flows freely in the room. We approached the nurse's station and asked what we need to do. The nurse asked if we were new and we said yes. She was very accommodating. We gave our confirmatory result and referral letter. She asked us to fill-out a form and directed us to sit down until we are called.

The nurse called us, took our vital statistics and weight, and assigned our H4 codes. She said that these will be used to identify us. It is a requirement that the patients' identities will be confidential. Then I noticed a familiar looking guy sitting at the waiting area, 8 feet away from me. I was not too sure if it was him since he was too skinny and the person I knew has somewhat a bit of weight. I looked at him again and he looked at me. Then we smiled at each other. Then I knew it was really X. X and I have been co-members in a PLU group. The last time I saw him was over 2 years ago already.

After the session with nurse, I sat on the couch behind X at the waiting area and tapped his shoulder. He turned his head and then I said, "Kumusta na? (How are you?)" 

He the jokingly replied, "Eto, may HIV ako (I have HIV now)."

He shared his story. He said that he got pneumonia a year ago, got admitted in the hospital and that's when he found that he has HIV. He didn't go back to see any doctor since then. He went back to the carefree lifestyle, drinking, smoking and partying all night. He decided to go to SLH that day because he was already scared with what's happening to his body. He noticed that he's drastically losing weight and he won't stop coughing. I said to him that it was a smart decision to see the doctor already and did not wait to be confined in the hospital again.

The nurse called me and assisted me to the doctor's cube. There I met Dr. Arcangel. She said that she would need some laboratory results for baseline like X-ray, CBC, Urinalysis, SGPT, SGOT, etc. I don't even know what the other laboratory tests are for. She also scheduled me for my baseline CD4 count 2 Thursdays from that day. She told me that the CD4 count will determine how strong my immune system still is. If my CD4 count is at 350 or below, I will be needing to take ARVs to suppress the virus from attacking my healthy cells in my body. Having a low CD4 count equates to being prone to opportunistic infections and I must avoid that. And if it's above 350, I just need to have a healthy lifestyle. She then asked me to return after I have completed all my baseline tests and CD4 count.

After my consultation with Doc, me and my friend went left H4 Pavilion to have our laboratory tests done outside. We went to different clinics and laboratories. We went back to the social hygiene clinic for our CBC, blood sugar and urinalysis. Then to an X-Ray laboratory then to a nearby laboratory for the other tests. I had my blood extracted twice on that day. One injection on each arm. I felt sore after those extractions.

We had lunch at Jollibee, a local fastfood, while waiting for some of the results. We started talking about what life would entail us now that we are HIV positive. Financial stress is not our worry as of the moment since we found out that we don't need to pay for anything for our consultations and ARVs. If we ever get confined in that hospital due to an illness or infection, we just need to pay a very minimal amount. What we are more concerned about is our CD4 count. We were both hoping that ours is still high so we can avoid the ARVs for now. We went back to the laboratories to get our results after eating.

Two weeks later, I arrived at STD AIDS Cooperative Central Laboratory (SACCL), which is also in the SLH compound, for my CD4 count. It is where all the bloodworks like CD4 count, Western Blot, Viral Load, etc are being processed. I went alone since my friend scheduled his 2 days earlier. When I got inside, there were several people already waiting. CD4 count is only being processed every Tuesday and Thursday, and they only accommodate 20 people per day that's why I was scheduled two weeks after my initial consultation. There was a mix of age in the room. About 5 are around in their early 20s. Most, including me, are in the mid 20s to early 30s. And 19 out 20 are males. 

The assisting personnel asked us to fill-out a form.When it was already my turn, I went inside a room. My blood was extracted and was put in two vials. After the extraction, I just went out of SACCL and headed to work.

I came back a week after for my baseline consultation with Dra. Arcangel. I gave her my laboratory results and she said that it's all fine. She then pulled out my CD4 count result. 442! I was so happy that it was above 350. Dra. explained to me that it is relatively high compared to others who go there where their CD4 counts are below 100 and they have opportunistic infections. But it is still low because the normal count is at least 800. She advised me to stay living a healthy lifestyle and avoid anything that can deteriorate my health. She said that my aim now is to get the numbers higher and get it on the normal level. I agreed with her. I said that my next CD4 count will be at least 500.

I went out of the pavilion and texted all my friends. I was happy with my results because I get to avoid the ARVs. Well at least for the next few months. I am scared to come to that point because of the several side effects that people are experiencing when taking it.

My friend got his result as well. It was 280. He was already advised to take ARVs starting January. I assured him that I will be there to support him. I know that having HIV is already a major change in our lives and taking ARvs, which you will need to take for the rest of your life, is another big change.

My next CD4 count is scheduled 6 months from that day. Hopefully it's 500 plus or won't go down below 442 at the least. I know that if I stay and live healthier, I will get the numbers that I want. I can do something about it. I know I can do it.

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