1st visit to the doctor and lab results

[loop78]

I just came back from my first doctor appointment. I liked her, she seems sensible, knowledgeable and caring. She did answer all my questions and was thorough, so I guess we had a good start.

And now the numbers. As I was fearing, they're not very good:

CD4 count: 235; CD4 %: 21,4%; VL > 50.000 (maybe it was > 500.000, I'm not sure about the number of zeros, over the test threshold anyway)

The rest of the test results were more encouraging: Hepatitis -ve, Syphilis -ve, Tuberculosis -ve, Toxo -ve, and the results of the pap smear were all negative also. Urine was ok, CBC was ok, and the Chem Screen results were also ok, though glucose was on the higher end and good cholesterol was a little low.

But let's go back to the CD4. According to my doctor we could be in two possible scenarios:

A) Recent infection, in which my numbers would be normal and should improve over time once an equilibrium is reached between the virus and my immune system.

B) Not so recent infection, which might mean I'm a fast progressor, though with only one lab result is difficult to tell. If this were confirmed by a second test, I would have to start treatment.

A little background so all of you get to assess the situation a bit better:

- I had a negative elisa on September 2004.
- After that, I had couple of safer sex encounters and, on November 2004, I started a monogamous long term relationship that lasted until January 2006. We had unprotected sex, I'm sure he was monogamous too and he had only had two sex partners before knowing me and he claims he always used a condom with them. I'm trying to get him to get tested, but he's saying he's going to wait till the end of the month, because he's got a very important exam then and doesn't want to lose his focus until he's passed it.
- From January 2006 till now I had unprotected oral, and around 5 episodes of "dipping". The rest was always protected.
- I experienced ARS consistent symptoms on April 2008.
- The doctor I went to works in small clinic specialized in HIV and has plenty of experience. However, as in my country HIV meds can only be given in Hospitals, if I would have to start treatment, she would have to send me to a hospital.

She gave me the option of either going directly to a hospital, in which I would have to have more blood work done in order to decide whether to start treatment or not, or staying with her and having another CD4 done one month apart from the last (which was the on May 21st) to see if there is an improving trend and treatment can be postponed. She also told me that though my CD4 count was low, my % was more encouraging.

I have decided to wait and see the second test results before doing anything, as this clinic is more accessible, they'll have the results really fast and I liked this doctor.

One more thing, after seeing my throat, she assured me whatever is causing my sore throat it's not thrush *sigh of relief* :-D

Hugs for everyone!

[Ann]

Hi Loop,

You're doctor has said pretty much what I would have said to you - and you've taken the same course of action I would have in your circumstances.

Keep hold of that doctor! It can be difficult to find a doctor you can develop a rapport with and it sounds like you've struck gold the first time out.

About your numbers, they are indeed consistent with recent infection. If they were because you were progressing quickly, I wouldn't expect to see such a robust CD4%. And about the VL, if she said it was over the test threshold, then it would be 500,000, not 50,000. Again, this is totally consistent with a recent infection.

Speaking of recent infections, it is quite possible one of the persons you engaged in dipping with was recently infected himself and had a similarly "through the roof" VL. We're more infectious when newly infected, until the body gets to grips with the virus and brings it under some semblance of control.

I'm happy for you that your first appointment was such a positive experience. Like I said, keep hold of that doc!

Hugs back at ya,
Ann

[BT65]

Hi loop,

Well, I can't add anymore to what's already been said by your doc and Ann.  You really won't know for sure until another couple rounds of labs. Your % is very good. You're very fortunate to have found such a knowledgable, good doctor.  I'm really happy for you.  Glad about your other test results also.  I've had esophageal thrush before-it's a nasty bugger. 

I'm glad you let us know what's going on and I hope we hear more from ya!
  Luv,
Betty

[Matty the Damned]

Hey Loop,

Just adding one more voice to the chorus here. As Ann says, those numbers are entirely consistent with a recent infection and will most likely stabilise with time.

Be well,

MtD

[loop78]

Hey again!

Thanks to the three of you for your answers, seeing you agreeing with my doc and my decision makes me feel I may actually still retain some sanity. Just maybe. :-P

We'll know for sure with more tests results, but at least now I know were I stand, can take it easy meanwhile, and if I finally have to start treatment it isn't the end of the world either.

Ann: Yeah, it seems I hit jackpot with my doctor... that's one of the motives I'm gonna try to stay with her if it's possible. You may be right about the way I became infected, I've thought about that possibility too... Let's see if my immune system finally grasps the concept of "bringing the virus under some semblance of control"!

Betty: Sorry to hear about your experience with thrush, I've had a couple of exes that would qualify as nasty buggers too... ;-) I intend to keep around here, so you'll surely hear more from me!

Matty: Thanks for joining the choir, your voice is always a fine addition. ;-)

Hugs!

[Ann]

Loop,

Try to keep yourself from getting too impatient - it can take a few months for your body to gain the upper hand. In the meantime, you can help the process by simply eating right, getting enough rest, keeping your life as stress free as possible and don't forget to laugh and enjoy life too. Laughter truly is the best medicine.

I've been med-free for eleven years now and you might get quite a few years too. You might not, but you might. Give it time and get a few results under your belt.

Ann

[BT65]

Loop, I totally agree with goderator Ann about laughter.  I watch comedy every day.  And there are things I can look back on now that are funny.  I try to laugh my ass off at least twice a day.