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Author Topic: First real meeting with my doctor, what do you think?  (Read 1790 times)

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Offline AaronbytheC

  • Member
  • Posts: 116
First real meeting with my doctor, what do you think?
« on: July 23, 2010, 12:24:11 PM »
We'll let me start by saying I loved her!   ;D  Both her and my RN were there for this.

After spending a good hour with me to do a physical, talk with me about my concerns and go over all of my labs in detail, she told me she wanted to wait a little longer to start meds.  ???  (I was like did you see that 307 CD4 count!?)  
She had all of the notes from my initial intake so she already knew the history of my exposure before I met her.  She said she had even taken the time to call a few of her colleagues to discuss my case and they agreed we should play it month by month for now.  
At first I didn't think I was comfortable with that and told her so, then she said you're an engineer so lets look at this logically on a time line...

  • June 2009 neg
2010:
  • Late Feb very high risk sexual encounter (with someone who is now know Positive)
  • Late March large rash appeared on stomach requiring a visit to and prescription from dermatologist
  • April low energy
  • May thru June vicious night sweats, the kind you are soaking wet and have to wash the sheets every morning!
  • June 2010 tested Poz


She said all of this is a classic road map of seroconversion and there is a very good chance my first labs are at my low and will bounce back tremendously...  Like 600 to 800 over the next 5 to 6 months.  
That just seems so optimistic to me, but she's the one with the medical degree, years of experience and the agreement of her colleagues.  She pointed out in the grand scheme of things my VL is pretty low given how new the infection is.  (I guess that is a good thing?)

I agreed to do another blood draw on 8/10 and see where the CD4's are.  If they go up I'll give here another month to prove her point...  If they go down I'm thinking I'm going to insist on meds.  In the meantime I already had them start the genotype testing a week ago (same day I got my first numbers...)  I'm not the type to sit back and wait for anything   ;D

After my meeting with the doctor I went to the local ASO where they were kind enough to stay a few hours late to meet me and get all of my paper work for ADAP.  They looked over all of my information and told me that I'd have no problem qualifying.  (Huge relief!)  So we did all of the paperwork to set me up so it will be ready when I'm ready.

Those of you who have been in my shoes already, do you think I'm making the right choice?  Should I wait if they improve or just bite the bullet and start meds for the rest of my life?  Good news is my doc said as long as my geno come back good she'll recommend Atripla as my treatment.
« Last Edit: July 24, 2010, 03:07:39 PM by AaronbytheC »
04/2012 CD4 721 / 29% / VL UD
02/2011 UNDETECTABLE!
12/2010 CD4 587 / 24% / VL 210
11/2010 Started Atripla
10/2010 CD4 420 / 18% / VL 13,500
09/2010 CD4 541 / 17% / VL 10,500
08/2010 CD4 498 / 18% / VL Not Taken
07/2010 CD4 307 / 18% / VL 9,500
06/2010 Confirmed Poz
03/2010 Infected
06/2009 Neg

Offline Miss Philicia

  • Member
  • Posts: 24,426
  • celebrity poster, faker & poser
Re: First real meeting with my doctor, what do you think?
« Reply #1 on: July 23, 2010, 12:31:43 PM »
Your doctor is correct -- as long as you monitor your situation monthly you'll do fine.  If at the end of three months things aren't as your doctor is hoping, then you both can re-evaluate treatment.

It's also great that you went through all of that ASO/ADAP paperwork quickly and have that behind you.  All said, it seems that you're mentally dealing with this very well and are also very organized!  Good for you.  Now treat yourself with something for the weekend :)
"Iíve slept with enough men to know that Iím not gay"

Offline max123

  • Member
  • Posts: 377
  • Carpe Diem
Re: First real meeting with my doctor, what do you think?
« Reply #2 on: July 23, 2010, 01:51:58 PM »
Your doctor is correct -- as long as you monitor your situation monthly you'll do fine.  If at the end of three months things aren't as your doctor is hoping, then you both can re-evaluate treatment.

It's also great that you went through all of that ASO/ADAP paperwork quickly and have that behind you.  All said, it seems that you're mentally dealing with this very well and are also very organized!  Good for you.  Now treat yourself with something for the weekend :)
i'm with ms. p on all of that  ;)
1/86 - 6/08 (annually): neg elisa
7/09: pos elisa/pos wb
8/09: cd4 560, cd4% 35, vl 13,050
12/09: cd4 568, cd4% 33, vl 2,690
4/10: cd4 557, cd4% 29.3, vl 6,440
7/10: cd4 562, cd4% 29.6, vl 3,780

Offline hotpuppy

  • Member
  • Posts: 555
Re: First real meeting with my doctor, what do you think?
« Reply #3 on: July 23, 2010, 02:55:31 PM »
10K viral load is not the same as undetectable.... yes it's good.  But your CD4 count is on the low side and even under pre-existing guidelines treatment is an option.

I don't want to take any bounce out of your situation, but you also need to know that you should be careful.  It's very easy for you to get sick in this range.  I'm basically in the same area with CD4s and I find that I get colds easier then when I'm at 480.

I certainly hope you bounce back that quickly.  My experience is that it takes longer.

The most important thing is that you like your doctor and her staff.  Equally important is that you trust her judgement.  There is certainly more to the equation then what you have posted, so I'm not trying to sharp-shoot your doc. 

If you haven't done so, I'd recommend going through the lessons on poz.com and looking into a HIV101 type course at your ASO.  They won't tell you to live in a bubble but they will help you identify some of the risks in your life when it comes to wellness.  In Houston it's called NextStep and our ASO teaches it.  However, most ASOs have a class like this.    As an example, one of the things they recommend avoiding our dishes with cracks or chips.  These apparently can harbor bacteria.  Another example is getting better about expiration dates and learning to avoid things that are expired by even a day.
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline AaronbytheC

  • Member
  • Posts: 116
Re: First real meeting with my doctor, what do you think?
« Reply #4 on: July 23, 2010, 04:34:20 PM »
Thanks for the input, I'll ask the ASO if they have anything like that.  I guess I never really thought about things like that...   :o

A bit of good news, the ASO called me about an hour ago and said my ADAP application was excepted and and I'm good to go until December of 2011.   ;D
04/2012 CD4 721 / 29% / VL UD
02/2011 UNDETECTABLE!
12/2010 CD4 587 / 24% / VL 210
11/2010 Started Atripla
10/2010 CD4 420 / 18% / VL 13,500
09/2010 CD4 541 / 17% / VL 10,500
08/2010 CD4 498 / 18% / VL Not Taken
07/2010 CD4 307 / 18% / VL 9,500
06/2010 Confirmed Poz
03/2010 Infected
06/2009 Neg

Offline bmancanfly

  • Member
  • Posts: 598
  • Medicare For All !
Re: First real meeting with my doctor, what do you think?
« Reply #5 on: July 23, 2010, 05:56:17 PM »
You didn't say when your first blood draw was.  Presumably, it was in July.  Having another blood draw on 8/10 seems too soon to really be useful.  I would want 2-3 separate bloods draws,  spaced out over six to nine months to determine what your real numbers are before making a decision about meds.  You're too close to sero-conversion to know for sure.

When I first tested poz my CD4 was 284 w/ a VL about 9500 (very similar to yours).  Both those numbers remained about the same for 5 years with no treatment.

In retrospect I wish I had started early.   There is a building consensus for starting earlier.  But you can't make a prudent decision until you have the data to base it on - and you don't yet.   Your CD4 could easily be much higher with your next blood work.  With your VL at 9500 there is no emergency.

Enjoy your good numbers and relax for awhile.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline BlueMoon

  • Member
  • Posts: 665
  • Calling from the Fun House
Re: First real meeting with my doctor, what do you think?
« Reply #6 on: July 23, 2010, 06:09:49 PM »
Sounds like you're in good hands.  I've had two different HIV doctors with highly contrasting styles, and I much prefer patient and thoughtful to bold and rushed.
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline tednlou2

  • Member
  • Posts: 5,054
Re: First real meeting with my doctor, what do you think?
« Reply #7 on: July 24, 2010, 11:30:25 PM »
I wish you all the best.  Your seroconversion story made me think how it affects all of us so differently.  I've talked to some who say they never got any kind of seroconversion illness.  Others had swollen lymph nodes while others had rashes and awful night sweats.  I dont' think I ever got any kind of rash or night sweats.  I went through seroconversion very soon after the infection while others take weeks.  I got the swollen lymph nodes and extreme fatigue within a week. 

Got off topic there but it just made me think how differently it affects all of us.

Offline AaronbytheC

  • Member
  • Posts: 116
Re: First real meeting with my doctor, what do you think?
« Reply #8 on: August 15, 2010, 07:49:41 PM »
Well I got my second set of numbers back on Thursday and I'll be darned if my doc wasn't right!  CD4's up nearly 200! (From 307 to 498) :o 

I can't describe the feeling that came over me when she told me...  Her exact words were, "well I got your labs back and they are Awesome!"   ;)  I tell you I slept like a baby Thursday night!

I have to admit I really did not believe that they could come up so much in one month but there they were right in front of me.  She told me that this is classic of a new infection caught this early.  She said she was not surprised at all and expects the draw from next month may be even better as my body is adjusting to this.

This changes everything...  Because of the first set of labs I was totally ready to start Atripla this week but now I'm happy to give her another month to prove her point.   ;D
04/2012 CD4 721 / 29% / VL UD
02/2011 UNDETECTABLE!
12/2010 CD4 587 / 24% / VL 210
11/2010 Started Atripla
10/2010 CD4 420 / 18% / VL 13,500
09/2010 CD4 541 / 17% / VL 10,500
08/2010 CD4 498 / 18% / VL Not Taken
07/2010 CD4 307 / 18% / VL 9,500
06/2010 Confirmed Poz
03/2010 Infected
06/2009 Neg

Offline mecch

  • Member
  • Posts: 12,079
  • red pill? or blue pill?
Re: First real meeting with my doctor, what do you think?
« Reply #9 on: August 15, 2010, 08:50:24 PM »
Reads like a good doc, to me. Hope you won't need HAART for awhile.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline leese43

  • Member
  • Posts: 257
Re: First real meeting with my doctor, what do you think?
« Reply #10 on: August 16, 2010, 01:39:57 PM »
Great news, really pleased  for you.

Leese x
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

 


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