please help me help my client

[daisy27]

I work for a hospice company. I recently admitted a client with HIV,heb B & hep C. The anti-viral meds were stopped aprox 1 week ago. My client is covered head to toe with a deep purple rash. The client is unable to make want or needs known. The MD states this is "The HIV" rash. I can not find info on the web regarding such a rash. Is there anyone out there that has had this rash? What can I do to help my client through this? As my client is hospice, the MD is not responding well. He  has  the "terminal" thought clouding his judgement. Please, anyone?

[Ann]

Daisy,

If the doc is calling that an hiv rash, he can't know much about hiv infection or the opportunistic infections we might suffer from.

It sounds as though your patient has a form of cancer called Kaposi's Sarcoma. It produces characteristic purple lesions on the skin and can also cause them in the esophagus and other internal organs.

I'm not sure what you can do for this patient, seeing as how medical assistance in the form of antiretrovirals has been withdrawn, other than make him as comfortable as you can. If he has no visitors, maybe you can arrange for a volunteer, perhaps from your local Aids Service Organisation.

I'm so sorry to hear about this patient. He sounds like someone who has, for one reason or another, fallen through the cracks.

While you're here, you might want to read through the Welcome thread, where you will find links to other sections of this website such as the Lessons. Check out the Opportunistic Infections section of the Lessons where you can begin to learn about Kaposi's Sarcoma.

Thank you for taking the time and trouble to make sure you are doing your best for this patient. Feel free to come back here if you need further advice. And by the way, I moved this thread into Living because it's a more appropriate place than Off Topic.

Good luck and feel free to keep us posted.

Ann

[aztecan]

I'm with Ann on this one. KS lesions look just as you describe and can become crusty or oozy.

If they are lining his esophagus and mouth, he probably will not be able to eat or swallow properly. One thing that has helped others is an anesthatizing rinse he can swish around his mouth and swallow.

Since ARVs have been withdrawn and, because we are talking hospice, chemo for the KS is not a consideration, about the only thing you can do is to make the person as comfortable as possible.

I have found that something as simple as holding the person's hand for a while often comforts them. Often, family or friends are afraid to touch someone who is in this state, but there is little danger because the virus that causes KS is present on everyone, but doesn't take off unless someone's immune system is severely compromised.

By the way, if the doc called this "HIV rash," he needs a refersher course - and perhaps a little knock in the head regarding his bedside manner.

HUGS,

Mark

[daisy27]

Thank you for your kind response. I visited my client today, and as you said, the rash has blistered and is oozing. I love my job and care for all my clients. They hurt....I hurt. I can honestly admit my company deals mainly with cancer, stroke and renal failure clients. HIV/AIDS is new to me. I have been a CNA/HHA for 13 years and I saw my first AIDS case in April of this year. I will read the lessons you suggest and educate my co-workers about the disease process. I pray for the day when people and medical professionals alike embrace HIV with compassion instead of apathy or fear. My client's MD needs to be educated as well.  Hospice is not just about dying. It's about living well until that time comes. Thank you, again.

[kcmetroman]

Good luck to you Daisy,

People like you CAN make a difference.

Bless you

John

[Eldon]

Hello Daisy27, it is Eldon. Welcome to the forums where you can find answers to your questions. I wanted to comment that you are correct in Educating yourself on HIV/AIDS. There is a lot of information available to you in the Welcome thread.

[joemutt]

Thank you Daisy for taking care of your patients and be such a giving person