A doubt regarding CD4 counts

[Raf]

Hi! I'm new on the forums (well, I have some weeks registered, but this is my very first post). My English is terrible, (I'm south american) so please bear with me.

I was diagnosed 3 years ago (a full blown aids diagnosis), back in May 2008. I was suffering from molluscum contagious infection and wasting syndrome (my weight fell from150 lbs to 125 lbs in only 2 or 3 months). When I got out my Diagnosis, I got directed immediately to one of the doctors on the institute (I got tested on an inmunology institute here in my country) and the doc inmediately signed me on the national aids program on my country, and gave me inmediately the meds (later I found that my CD 4 count was 98, and my VL was over the roof, I cannot remember the number right now). I've been under the kaletra + combivir treatment during the last 3 years, and my CD4 count progressed up continuously, and after 6 months my VL was undetectable (to this day).

However, I've seen a drop on my CD4 count for the first time in 3 years. In my last check (in february) , my CD4 count was 325 (VL undetectable), but scared me to death since my last CD4 count back in september 2010 was 480.

I went to see the doctor the last week and he said that I should not worry about this, my VL is still undetectable, and he'll need more data on future checks ( I'll have my next VL and CD 4 check on july/august). But the question still haunts me, and I thought that here is the best place to ask, specially with people living with HIV longer than me.

There are CD4 fluctuations? or they have to go up constantly and one drop maybe mean that my treatment is not working anymore? Agh..I'm still trying to cope with my emotions and feelings (after the diagnosis I wasn't the same) and now I don't like to deal with more worries (for the record, since my diagnosis, I became 100% reclusive, no sex, hookups or anything...I'm not sure if I'll be able to regain my former confidence to find a partner anymore, so reinfections are out of the question). Maybe I'm just paranoid and I just only trust my doc, but I don't have anyone to talk about this besides him.

Thank you for your time

[Rev. Moon]

Raf,

First of all, welcome to our forums, glad that you found us, and all that good stuff 

Second, your English is not "terrible" whatsoever; it is actually quite good.

And then let's talk about those CD4.  The recent fluctuation is not something that you should be too worried about.  Absolute CD4 counts can vary easily (sometimes in a matter of just hours, depending on when the sample was taken) as they are influenced by various factors.  What matters most is that you remain undetectable.  If you have been given your CD4 % then you will probably see that things are pretty much the same.  As we often say around here what matters when it comes to HIV values are the trends.  You have come back from a pretty low point in a decent amount of time.

So don't stress too much.  Trust your doctor and keep taking care of yourself.

Now, as far as living a reclusive life... That is understandable, but make sure to address this (if you haven't had a chance you may want to discuss this with a therapist; it can do wonders when it comes to living with HIV). You are the same person that you were before this diagnosis.  You have HIV, HIV doesn't have YOU.

Hope you stick around and get to know us better.

Best,

Tha Rev.

[Raf]

Thanx for your reply rev. It seems that is like my doc said, I shouldn't have doubted him.

And yes, I know that I have some metal issues, that got worse since my diagnosis (I only got out from my home to work, and after work directly to home. Only 3 months ago I convinced myself to go to the gym to train)...I'll have to deal with this sooner or later, I fear that I'll have an emotional meltdown in the future (I'm not the one who like to speaks opnly about feelings and emotions).

I'll keep that in mind, thanks again. I'm glad I found this forum too...it's refreshing to have a place (even if it's on the internet) to speak (or write in this case) about this.

[Matty the Damned]

Thanx for your reply rev. It seems that is like my doc said, I shouldn't have doubted him.

And yes, I know that I have some metal issues, that got worse since my diagnosis (I only got out from my home to work, and after work directly to home. Only 3 months ago I convinced myself to go to the gym to train)...I'll have to deal with this sooner or later, I fear that I'll have an emotional meltdown in the future (I'm not the one who like to speaks opnly about feelings and emotions).

I'll keep that in mind, thanks again. I'm glad I found this forum too...it's refreshing to have a place (even if it's on the internet) to speak (or write in this case) about this.

Raf,

The Rev is wise about this. Absolute CD4s can fluctuate quite wildly. Like the Rev, I'm willing to be your CD4 % tells a much more stable story.

Have you considered some counselling or other sorts of mental health support? Sounds like you have a pretty bad case of depression fucking with your shit.

MtD

[wolfter]

Welcome to the forums.  Your English, grammar and writing style is better than a lot of the posters here. 
As others have mentioned, fluctuations in your CD4's is normal. 

Have a great day

Greg

[Raf]

Thanks for confirming it Matt and wolfter, I was a bit stressed, even after I talked with my HIV doc. I'll put this subject behind then, and wait for my next check.

And yes Matt, I think I suffer depression, since my dx and I haven't overcome it yet, and my social skills have deteriorated a lot since then. I have the advantage that everyone in my house knows that I'm poz (my mom,dad,aunt and my sister) and helped me through this, specially when I was diagnosed, and my meds are paid by the government...reading through these forums helped me to realize that maybe I'm very lucky and I have to try my best to overcome it. Actually I try to not think about it, keeping myself busy, by work (I'm a software engineer) or playing videogames, listening music (and recently doing exercise) and most of the time I succeeded..but there are times when my depression kicks in again (like last week) and becomes harder to manage it each time. I'll ask my doc in my next appointment about these things, and where I can get some counseling, or at least a support group.

Ah...I went with the wall of text about my mental issues...sorry for the off topic. Again, I'm glad I've found this forum, reading it help me a lot, and I'll try to contribute here from now on too.

[Matty the Damned]

Thanks for confirming it Matt and wolfter, I was a bit stressed, even after I talked with my HIV doc. I'll put this subject behind then, and wait for my next check.

And yes Matt, I think I suffer depression, since my dx and I haven't overcome it yet, and my social skills have deteriorated a lot since then. I have the advantage that everyone in my house knows that I'm poz (my mom,dad,aunt and my sister) and helped me through this, specially when I was diagnosed, and my meds are paid by the government...reading through these forums helped me to realize that maybe I'm very lucky and I have to try my best to overcome it. Actually I try to not think about it, keeping myself busy, by work (I'm a software engineer) or playing videogames, listening music (and recently doing exercise) and most of the time I succeeded..but there are times when my depression kicks in again (like last week) and becomes harder to manage it each time. I'll ask my doc in my next appointment about these things, and where I can get some counseling, or at least a support group.

Ah...I went with the wall of text about my mental issues...sorry for the off topic. Again, I'm glad I've found this forum, reading it help me a lot, and I'll try to contribute here from now on too.

I ain't a doctor babe, but I'm pretty sure you're gonna get a diagnosis of major depression.

Depression is awful and very common amongst our kind. Check out our Mental Health forum, where you can discuss your mental health issues in peculiar detail with others who are interested and understand what you're going through.

That said, remember that depression is eminently manageable. With the right support and medications you can rid yerself of that black dog. 

MtD

[Rev. Moon]

Raf,

Depression is a very common byproduct of living with HIV.  You sound like a clever fella who actually happens to have a decent support system.  Take advantage of this and make a serious effort to take back your life; it takes longer for some people --the key thing is not to get stuck in a world of loneliness and melancholia.  People need people.  The fact that you have returned to the gym is a good sign that you are taking the first steps in order to continue moving on with life.  If having a boyfriend is something of high priority on your list then give it some time.  You need to accept you status and give yourself some love before you pursue a relationship.  

Don't be afraid of sex; you NEED it, we all need it.  The monster known as superinfection is not as common as some believe (you just got to take care of yourself as there are other nasty critters out there).  

As you can see after three years of being poz you're gonna be fine.  We are here if you need to vent or have questions.

[Raf]

matty, thanx for pointing me out to that sub forum, I'm reading it and I'll participate later, it's really interesting. And by the way, I've been reading about depression on this site, and I seem to have a lot of symptoms there...it's not easy for me to talk about feelings, depression and such stuff, even with my doc (outside of my house I pretend to be a very secure and stable individual..but sometimes I fail at it) but I'll have a chat with him in my next appointment.

Meanwhile, reading this forum has helped me a lot, maybe I'm just a drama queen and I should realize my current advantages and step up, even a bit.

Rev, very good point you have there. I have a "fear" (if we can call it like that) of sex since my diagnosis, in part from the superinfection, in part for infecting someone else. I know, I know, it's my first duty to inform ANY sexual partner about my status and have safe sex above everything else...but still, I prefer to save everyone else from that possibility by not having sex at all, and at least I'll avoid the (almost sure) rejection I'll get from now on.

It's very silly..I remember when I was diagnosed  back in May 2008, I had a "friend" who might be a possible BF..but after the dx, he was one of the few persons outside my home I told my status (even though we had safe sex everytime).I informed him that same month, and he seemed supportive and caring..but I kept my distance to him because I thought he will be better without someone HIV+ near him, and I haven't talked to him in 3 years, and I don't plan to. Well, now that I think, in that moment I was very skinny (my weight dropped to 130 lbs, and I was suffering from molluscum contagious, my self image was below ground I don't wanted him to see me like that (in fact, in that moment I didn't wanted anyone to see myself like that, maybe that boosted my reclusion that time).

Someday I'll start looking for someone...but at the moment I'll focus on myself, to regain my self confidence, that's why I returned to the gym, I want to improve my body a bit.

Whoa, this post is maybe suited for the mental heath forum, so I'll write about these issues there in the future. So I just wanted to thank you for helping with my doubts. It's nice to find places like these where I can write about these things.

[SunnyFlorida]

Hey Raf... There's not much I can add because I'm a neggie, but I can say this... Definitely get back into being more physically active. I've been depressed for several months now due to having lost my job, a car accident, issues with friends, grandparents' health, etc. I tried to commit suicide by overdosing myself on prescription meds on New Year's Eve. Obviously that didn't work, and I have no long-term repercussions, thankfully! I just woke up with a MAJOR headache on New Year's Day. (WOW! I have never told this to anyone, ever, let alone openly on a forum!)

Recently I've been getting myself out there, spending my evenings walking. Ever since I started, I've lost 16 pounds/7.25kg and my mood has never been better! Things around me are still bad, but because I've been more physically active, I find myself being able to handle crises that arise. This is because of endorphins that are produced during exercise, excitement, etc.

I highly recommend you get into some sort of regular physical activity. I walk five times a week, anywhere from 3-6 miles/4.5-8km. Each morning, I wake up all smiles, ready to leap out of bed and conquer the day! Not to mention the health benefits such as improving your immune system!