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Author Topic: elective surgery and disclosure  (Read 4845 times)

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Offline vegaslocal39

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  • Posts: 50
elective surgery and disclosure
« on: December 20, 2006, 11:42:39 AM »
I would like to have some minor elective surgery done by a dermatologist.  Undoubtedly there will be blood involved.  The primary question is, do I have a duty (moral, ethical, or otherwise) to disclose my status to the doctor?

It seems to me that the same precautions should be taken with every surgical procedure.  So as long as I'm not putting anyone at risk, why should I have to disclose?

On the other hand, does the doctor have a right to know?  I'm afraid that if I disclose, they will refuse to do the procedure, because it is elective.

Secondly, I've always been curious to know if dentists test their patients without permission?  Aren't there some "instant" swabs out there these days?  I did not disclose to my dentist.  Maybe that was wrong of me.

Finally, why do dermatologists/dentists even ask about a potential patient's status?


Offline ACinKC

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Re: elective surgery and disclosure
« Reply #1 on: December 20, 2006, 11:52:15 AM »
Yes.

Because youre putting yourself at risk.

And no they dont test.

And they need to know of ALL health related issues because of medicine reactions and what not.

Those are my simple answers.


NOW....im also a hypocrite, i havent told my dentist either, but im 95% sure my mom has/who has a large mouth and shares the same dentist who we have had for 15 years.
LIFE is not a race to the grave with the intention of arriving safely
in a pretty and well-preserved body, but, rather to skid in broadside,
thoroughly used up, totally worn out, and loudly proclaiming--WOW! WHAT A
RIDE!!!

Offline David_CA

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Re: elective surgery and disclosure
« Reply #2 on: December 20, 2006, 11:55:34 AM »
I had a benign tumor removed from a finger this past summer.  I told the PA the day before the surgery that "by the way, I'm HIV+, if that makes any difference".  She asked what meds I was on so she could add them to the list of what drugs I was taking, but at the time I wasn't on HAART yet.  My incision healed really quickly and she remarked something like 'Wow, HIV sure didn't keep you from healing a lot faster than normal'.  I figured it wouldn't change anything, but that it would be good practice for me in disclosing.  On the other hand, I haven't told my dentist, despite there being a check box for HIV+ under medical conditions.

David
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
02-13-12 CD4 911 @41.4% VL<20
You must be the change you want to see in the world.  Mahatma Gandhi

Offline Lisa

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Re: elective surgery and disclosure
« Reply #3 on: December 20, 2006, 12:02:27 PM »
It is true that all medical personnel use universal precautions for procedures, but I always tell any body who sees me for anything....so that I am getting the best care I can.
Some of the meds do terrible things to your teeth. It is important for your dentist to know because your teeth, and supporting structures are just as available to infectious problems as your upper respiratory tract. And some antibiotics are counterproductive to some of the HIV meds. For instance, Ifound out through trial, and error, that I shouldn't be using Biaxin because of my Trizivir.(I think it was the Trizivir, or the Viramune one) once we switched over to a different ABX I was good as new.
It's not like they are going to disclose your status to anyone else, and the quality of your care should not change because of your status. If it does......find a doctor not living in the dark ages.
Just my take on the issue.(but then...I am a medical professional in practice for thirty years)
No Fear  No Shame  No Stigma
Happiness is not getting what you want, but wanting what you have.

Offline poet

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Re: elective surgery and disclosure
« Reply #4 on: December 20, 2006, 12:11:39 PM »
Yes, everyone in healthcare is supposed to follow universal precautions, but, as we often read, not everyone in healthcare does so.  I would turn the issue around a bit and ask, 'would you want to know that your being hiv positive is not going to affect the quality of patient care from a provider and, if so, how else can you find that out except by disclosing ahead of any procedure?'  If someone reacts in a negative way, you would then know, prior to using their services, that this medical office is not a good choice for you.  As the others have pointed out, your healthcare is interrelated.  A procedure by a dentist or a dermatologist should be made known if only by name of the provider to your main healthcare provider.  If something does happen which is unexpected, wouldn't you want everyone talking to each other and on the same page? Win
Winthrop Smith has published three collections of poetry: Ghetto: From The First Five; The Weigh-In: Collected Poems; Skin Check: New York Poems.  The last was published in December 2006.  He has a work-in-progress underway titled Starting Positions.

Offline AustinWesley

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Re: elective surgery and disclosure
« Reply #5 on: December 20, 2006, 12:17:52 PM »
What kind of elective surgery if I may ask?   You mention it's a dermatologist's office.   If this was Botox or something like that I doubt I'd bother telling them.  

But I agree that if you are going to be prescribed any antibiotics or other drugs you should make sure there aren't any problems if you are taking any HIV meds.

Lastly, I had a surgery a couple months ago to correct a deviated septum (for breathing).   I was a little aprehensive, but my doctor didn't even flinch over it or any of the nurses.   They said they already treated every paitient as if they already had HIV because there were a host of other communicable diseases besides HIV.  

I wasn't treated with any kind of discrimination whatsoever, but I haven't been to the dentist yet.   I would imagine it would be the same kind of situation.
Diag. 3/06  Infected aprx. 2 mo. Prior
Date        CD4   %      VL
4/6/06     627    32    36,500     NO MEDS YET!
6/7/06     409    27    36,100
8/23/06   408    25     22,300
1/2/07     354    23     28,700
2/9/07     139    30     23,000  Hep A Vaccine same day???
2/21/07   274    26     18,500 
3/3/07    RX of Truvada/Sustiva Started.
4/5/07    321     27      Undectable 1st mo.  
5/16/07  383     28    Undectable 2nd mo.
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Offline vegaslocal39

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Re: elective surgery and disclosure
« Reply #6 on: December 20, 2006, 12:58:04 PM »
Thanks guys.  I will bite the bullet and disclose.

Now, what to do about my dentist?  I am very particular about my teeth, so I visit every three months, instead of every six.  Kind of weird to go back in there now and tell them I didn't disclose on my initial visit.

Boy, do I feel like jerk now!


Offline David_CA

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Re: elective surgery and disclosure
« Reply #7 on: December 20, 2006, 01:10:38 PM »
Thanks guys.  I will bite the bullet and disclose.

Now, what to do about my dentist?  I am very particular about my teeth, so I visit every three months, instead of every six.  Kind of weird to go back in there now and tell them I didn't disclose on my initial visit.

Boy, do I feel like jerk now!

I'm kinda obsessive about my teeth too, but I only go to the dentist twice a year.  They always comment on how clean my teeth are (floss daily and brush often).  I figure that as long as everything is in good shape in there with no problems, I wouldn't worry about it.  They poke and probe every part of my mouth, tongue, teeth, and gums, so I feel comfortable with not disclosing at this point.  If I had issues with my mouth or teeth, I would disclose.

David
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
02-13-12 CD4 911 @41.4% VL<20
You must be the change you want to see in the world.  Mahatma Gandhi

Offline dixieman

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Re: elective surgery and disclosure
« Reply #8 on: December 20, 2006, 01:49:15 PM »
First question... What part of the country do you reside? I have found doctors, dentists, etc... in larger cities alittle less shocked by an hiv+ disclosure.... also, hep A-B-C are more likely to have you turned away to an infectious disease practioner than hiv+ and more than likely they are already informed by the network of insurance companies and the listings kept by the CDC and other governmental agencies... hiv is more common place than many people think...

Offline vegaslocal39

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Re: elective surgery and disclosure
« Reply #9 on: December 20, 2006, 04:31:00 PM »
I'm in Las Vegas, a big city, but it can be kind of "rednecky" at the same time.

I had no idea that insurance companies and government agencies were in the business of disclosing my status to medical providers.  So much for privacy.

Offline Coffeechick88

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Re: elective surgery and disclosure
« Reply #10 on: December 20, 2006, 04:47:55 PM »
I would say disclose as long as you are in an HIV friendly area.  I've found that those areas tend to be in bigger cities, where they are more likely to have HIV positive people (well those that would admit they are HIV positive).  I am in the healthcare profession and I can assure you that even though we are supposed to use universal precautions and abide by HIPAA--it doesn't always happen.  That is why it is best to be in an HIV friendly place that respects you.  My area is a small town area and not a good place for someone who is HIV positive to be in.  They still bring down specimens to me and say, Be careful because this patient has HIV and believe you me if I actually got my labwork done here, you can believe my status would be all over the hospital.  The other big hospital I was at, your ass would be fired if either of the above happened.  Both of the above things I mentioned are illegal.  Unfortunately, not all health care has caught up.  The universal precautions are adequate to protect us all from exposure.  They would definitely test in the event of a needle stick as part of protocol and to see whether to recommend PEP for the employee that was exposed.

But you should be okay in your area.  If you go to the right place, they will treat you as an equal.  Now, my situation sounds bad, but it is not norm--it is mainly rural areas that have more uneducated people that this happens in.  Disclosing could help them look for issues HIV positive people are prone to, make sure they don't give anything that medications would interact badly in.

No, they will not test you without your consent.  Not only would they risk a lawsuit if you found out, but there can be fines, jail time, etc depending on how bad the situation is--usually if they not only test without consent but also improperly disclose.
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Born 6-14-08 at 1233 am
8 lbs 14 oz, 22 in long

Offline aupointillimite

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Re: elective surgery and disclosure
« Reply #11 on: December 20, 2006, 04:51:34 PM »
I made a point of telling all my doctors, if only to improve the level of the care I'm getting.

My dentist looks at what's going on in my mouth a lot closer, and when I told my optometrist, she made a point of looking at my retina more closely than normal because I have CMV.

I would tell them because, let's face it, HIV is a serious pre-existing condition that they should know about because it can cause potential complications that they'd be able to better anticipate when they know.
Your tastebuds can't repel flavor of this magnitude!

Offline Coffeechick88

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Re: elective surgery and disclosure
« Reply #12 on: December 20, 2006, 04:54:30 PM »
I made a point of telling all my doctors, if only to improve the level of the care I'm getting.

My dentist looks at what's going on in my mouth a lot closer, and when I told my optometrist, she made a point of looking at my retina more closely than normal because I have CMV.

I would tell them because, let's face it, HIV is a serious pre-existing condition that they should know about because it can cause potential complications that they'd be able to better anticipate when they know.
I definitely agree, but again that is why one must go to an HIV friendly place, because otherwise the knowledge you are HIV positive can hurt your medical care if you do not go to a good place.
Lucas James is here
Born 6-14-08 at 1233 am
8 lbs 14 oz, 22 in long

Offline aupointillimite

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Re: elective surgery and disclosure
« Reply #13 on: December 20, 2006, 04:59:14 PM »
I definitely agree, but again that is why one must go to an HIV friendly place, because otherwise the knowledge you are HIV positive can hurt your medical care if you do not go to a good place.

That's why when I make the appointment, I tell them I'm poz and ask if that's going to be a problem.  I've yet to hear anything other than "This is the 21st century.  Why would it be a problem?"

Perhaps I'm lucky, but I find that being upfront from the get-go makes everything go easier.
Your tastebuds can't repel flavor of this magnitude!

Offline Coffeechick88

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Re: elective surgery and disclosure
« Reply #14 on: December 20, 2006, 05:05:30 PM »
I'm just overly paranoid I guess.  It's just that small area I work at, and the doctor that did my pre-employment physical not only didn't know what my medications were for, but once I told her, thinking there was no problem, she then refused to clear me to work, and I basically had to fight for the right to work there---and this is a hospital, where I am a lab rat with patient contact, but not such that I am doing major surgery.  Finally the attorneys had to advise them it was illegal to barr me from working and public health specialists told them it was no problem.  I was just fresh out of school, so other job opportunities were not as easy to get.  Then there was the gyno that was very forceful in trying to explain why I should be sterilized.  Then there is the gossipy people I work with.  So I realize that type of ignorance isn't common among the healthcare field, it's just made me paranoid of every doctor I see.....
Lucas James is here
Born 6-14-08 at 1233 am
8 lbs 14 oz, 22 in long

Offline aupointillimite

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Re: elective surgery and disclosure
« Reply #15 on: December 20, 2006, 05:30:50 PM »
Good Lord... I suppose there is an upside to living in cities, no matter how big they're not.

I suppose my positive experiences with doctors and nurses regarding HIV have made me not consider that some medical pros are still stuck in a 1985 mindset. 

A doc advised sterilization because your poz?  Call him Dr. Josef Mengele.  A lot.  He'll appreciate that.  I promise.   ;) 
Your tastebuds can't repel flavor of this magnitude!

Offline jntmax39

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Re: elective surgery and disclosure
« Reply #16 on: December 20, 2006, 05:40:44 PM »
I went to a Dentist to have my tooth pulled and I told him, then he looked in my mouth and said all your teeth need to be pulled,then he smacked me with a bill of 400 dollars for one tooth, Then I said to him you crazy I'll let these bitches fall out and he laghed. I'm on medicare and they don't cover dental

Offline Longislander

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Re: elective surgery and disclosure
« Reply #17 on: December 20, 2006, 06:24:01 PM »
Hey Vegas, I had been seeing a new dermatologist since I tested pos. I mostly see the PA, and she's young and adorable!! Imagine, it took me many many visits before I finally got the nerve up to tell her, just for her sake. She was so cute about it, and she's the highlight of any of my Dr visits!


AUP  Thanks for pointing out how you told the dentists. I've been wondering about telling the dentist. I have to find a new one and I couldn't imagine them asking me all kinds of questions at that window, when the room is full to the rafters with people waiting. Great idea.
infected 10/05 diagnosed 12-05
2/06   379/57000                    6/07 372/30500 25%   4/09 640/U/32% 
5/06   ?? /37000                     8/07 491/55000/24%    9/09 913/U/39%
8/06   349/9500 25%              11/07 515/68000/24     2/10 845/U/38%
9/06   507/16,000 30% !          2/08  516/116k/22%    7/10 906/80/39%
12/06 398/29000 26%             Start Atripla 3/08
3/07   402/80,000 29%            4/08  485/undet!/27
4/07   507/35,000 25%            7/08 625/UD/34%
                                                 11/08 684/U/36%

Offline aupointillimite

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Re: elective surgery and disclosure
« Reply #18 on: December 20, 2006, 06:27:42 PM »
LI- 

I actually told the dentist because I wondered if there was any sort of precusory stuff I should do before getting my teeth cleaned (some people have to take antibiotics for heart conditions)... so when I told them, the receptionist was like, "OK... annnnnnd?"  Yeah. 

Of course the hygienist used gloves, but they used absolutely no more precautions on me than they did when I was negative.  They did say that clean tooths/gummies were much more important to me now... but it was so not a big deal.
Your tastebuds can't repel flavor of this magnitude!

Offline Longislander

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Re: elective surgery and disclosure
« Reply #19 on: December 20, 2006, 06:31:04 PM »
since getting such a good reaction from the Derm, I would want to tell the dentist~
I was just having nightmares over the receptionist sliding that glass over and telling the waiting room! Thanks again, I'm going to tell when I first call.

About finding an HIV friendly dentist, I asked my ASO if they had someone to recommend and all they had was a clinic. So I guess it will be a call and guage the reaction kinda thing!?
infected 10/05 diagnosed 12-05
2/06   379/57000                    6/07 372/30500 25%   4/09 640/U/32% 
5/06   ?? /37000                     8/07 491/55000/24%    9/09 913/U/39%
8/06   349/9500 25%              11/07 515/68000/24     2/10 845/U/38%
9/06   507/16,000 30% !          2/08  516/116k/22%    7/10 906/80/39%
12/06 398/29000 26%             Start Atripla 3/08
3/07   402/80,000 29%            4/08  485/undet!/27
4/07   507/35,000 25%            7/08 625/UD/34%
                                                 11/08 684/U/36%

Offline aupointillimite

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Re: elective surgery and disclosure
« Reply #20 on: December 20, 2006, 06:34:54 PM »
since getting such a good reaction from the Derm, I would want to tell the dentist~
I was just having nightmares over the receptionist sliding that glass over and telling the waiting room! Thanks again, I'm going to tell when I first call.

About finding an HIV friendly dentist, I asked my ASO if they had someone to recommend and all they had was a clinic. So I guess it will be a call and guage the reaction kinda thing!?

From what I understand, it's extremely rare (and especially for you, living near New York) for any doc or dentist to refuse treatment on the grounds that someone is poz. 

And if the receptionist told anyone, you'd be in lawsuit heaven.  I work for an answering service for doctor's offices, and I'm bound by HIPAA laws.  Yeah.  They're uber-strict. 

I was worried about telling my other docs and my dentist... but it seemed to be such a non-issue to them.
Your tastebuds can't repel flavor of this magnitude!

Offline Tucsonwoody

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Re: elective surgery and disclosure
« Reply #21 on: December 20, 2006, 06:35:25 PM »
Laws like this may not matter to some medical people or they may not be aware but this is part of the info on the American Dental Associations site:

Duty to Treat

As a general rule, dentists have a legal obligation to treat HIV-infected individuals, including patients of record and other persons who seek treatment when the office is accepting new patients. Under the Americans with Disabilities Act (AwDA) and many similar federal, state and local laws, a person with HIV is considered as having a "disability," as are persons who are perceived to have HIV, which may include patients who have had blood transfusions and openly homosexual patients. at should be noted that HIV is only one of many infectious diseases that are considered as disabilities under the AwDA and similar laws; e.g., hepatitis B and tuberculosis are also treated as disabilities). In a case decided shortly before the publication of this text, the first federal court ruling on a charge of HIV discrimination against a dentist upheld the constitutionality of the AwDA

Full article at: http://www.ada.org/prof/resources/topics/hiv/ethics.asp

Here is a link to the federal site that goes into greater detail about ADA etc.  http://www.hhs.gov/ocr/hivaids/

Kevin
« Last Edit: December 20, 2006, 06:42:01 PM by Tucsonwoody »
And I wished for guidance, and I wished for peace
I could see the lightning; somewhere in the east
And I wished for affection, and I wished for calm
As I lay there - Nervous in the light of dawn

Offline Razorbill

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Re: elective surgery and disclosure
« Reply #22 on: December 20, 2006, 07:26:33 PM »
I disclose to all doctors, no matter what the procedure.  Everywhere and anywhere you can manage to disclose (and I know there are limitations) is one less secret to bottle up inside you and one less worry to carry.  I absolutely have told my dentist.  Given the procedures and the blood - it's the only ethical thing to do.

Offline Eldon

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Re: elective surgery and disclosure
« Reply #23 on: December 20, 2006, 07:28:48 PM »
Hey Vegas...

You made the right choice when it comes to disclosing to your dentist.doctor. It is good for them to know in case there is a problem with the proceudre.



"Don't Give Up, Don't Give In... Cause it is ALL within you to WIN!"

Offline poet

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Re: elective surgery and disclosure
« Reply #24 on: December 20, 2006, 07:47:02 PM »
Paul, there are any number of hiv positive positive dermatologists and dentists in Manhattan, so if you ever are in need of someone and travel isn't the issue, keep this in mind. 

Back to the question about disclosing to your dentist after the fact, just be honest.  It's awkward for you to bring up the subject.  Your voice is going to show this.  If they are an understanding (read human based) practice, they will get it right away.  If not, again that tells you something you might want to know.  Win
Winthrop Smith has published three collections of poetry: Ghetto: From The First Five; The Weigh-In: Collected Poems; Skin Check: New York Poems.  The last was published in December 2006.  He has a work-in-progress underway titled Starting Positions.

Offline Longislander

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Re: elective surgery and disclosure
« Reply #25 on: December 20, 2006, 09:00:17 PM »
lawsuit, hmmm, could use some cash..............lol

Win, it was hard enough telling the cute PA at the derms, I'll disclose when making the dentist apt by phone. If they look at me funny when I get there, I'll threaten LAWSUIT!! (lol)
And I'm done with going to NYC for a doc after my ASO experiences!!
infected 10/05 diagnosed 12-05
2/06   379/57000                    6/07 372/30500 25%   4/09 640/U/32% 
5/06   ?? /37000                     8/07 491/55000/24%    9/09 913/U/39%
8/06   349/9500 25%              11/07 515/68000/24     2/10 845/U/38%
9/06   507/16,000 30% !          2/08  516/116k/22%    7/10 906/80/39%
12/06 398/29000 26%             Start Atripla 3/08
3/07   402/80,000 29%            4/08  485/undet!/27
4/07   507/35,000 25%            7/08 625/UD/34%
                                                 11/08 684/U/36%

Offline bocker3

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  • Posts: 3,369
  • You gotta enjoy life......
Re: elective surgery and disclosure
« Reply #26 on: December 21, 2006, 07:41:15 AM »
I personally think one should disclose to ALL medical/dental contacts -- and I have.  Why??  Not so much for their safety -- that's why Universal precautions should be followed -- but because it is a very important piece of your medical history.  You certainly want anyone who may use and/or prescribe medications for you to know what HIV meds you are taking to insure that they don't give you anything that would interact.  Also, many HIV related "issues" can occur in the mouth and your dentist doesn't just examine your teeth -- he/she should be examining your entire oral cavity.  So don't look at this as whether you should do it for THEIR safety -- look at as whether you should do it for YOUR safety.  Since I told my dentist, the only difference in my treatment is that he probably spends a little more time looking around in my mouth (I'm there every six weeks because I have Invisalign braces right now) and he now always wears his safety glasses, whereas before, sometimes he did and sometimes he didn't.
Remember, if you are uncomfortable talking to a medical provider about your medical history -- it's probably time to consider changing that provider.  Your local ASO may be able to help you find someone who has others in their practice with HIV.

Good luck
Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline geostud

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  • Posts: 4
Re: elective surgery and disclosure
« Reply #27 on: December 21, 2006, 01:22:42 PM »
I know that I certainly disclose to my dentist, doctors, etc.  While I don't think you have any legal requirement to disclose, they have a legal obligation to treat you, in spite of your status.  I just think it is as fair to disclose to medical professionals who are taking care of my health, as it is to disclose to someone I'm going to have sex with.  Yes, there will be the occasional fearful practitioner (I've experienced them, where they come at me with almost class A protective gear on) but put yourself in their place.  If you were negative and treating someone, wouldn't you want to know if they were positive?  If there was an accident, like a needle prick, they could take medication to attempt avoiding infection.  If they don't know, they won't do that.  Besides, a dentist, for example, might want to give you an antibiotic because of your status that he wouldn't prescribe a person who is not infected.  This is a hard one to wrestle with.  Good luck!

Offline Coffeechick88

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Re: elective surgery and disclosure
« Reply #28 on: December 21, 2006, 02:03:44 PM »
I know that I certainly disclose to my dentist, doctors, etc.  While I don't think you have any legal requirement to disclose, they have a legal obligation to treat you, in spite of your status.  I just think it is as fair to disclose to medical professionals who are taking care of my health, as it is to disclose to someone I'm going to have sex with.  Yes, there will be the occasional fearful practitioner (I've experienced them, where they come at me with almost class A protective gear on) but put yourself in their place.  If you were negative and treating someone, wouldn't you want to know if they were positive?  If there was an accident, like a needle prick, they could take medication to attempt avoiding infection.  If they don't know, they won't do that.  Besides, a dentist, for example, might want to give you an antibiotic because of your status that he wouldn't prescribe a person who is not infected.  This is a hard one to wrestle with.  Good luck!
About a possible needlestick incident, the usual protocol involves testing both patient and employee.  The patient gets tested for Hep B, C and HIV and the employee gets baseline labs and also to check the Hep BSAb titer.  They don't just go by not knowing.  Based on the results and the incident they may or may not prescribe PEP.  Anyhow, universal precautions--they are to treat everyone as if they were positive.
Lucas James is here
Born 6-14-08 at 1233 am
8 lbs 14 oz, 22 in long

Offline bocker3

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  • Posts: 3,369
  • You gotta enjoy life......
Re: elective surgery and disclosure
« Reply #29 on: December 21, 2006, 02:23:17 PM »
I know I'm repeating myself, but..............................

The best way to approach why you would want to disclose to medical and/or dental professionals who are treating you is more about insuring YOUR safety and proper treatment vs. THEIR safety.  This takes any "ethics" concern out of the equation and puts the onus of this where it belongs -- on you and your RESPONSIBILITY to take proper care of yourself.  I know disclosure is scary, but so is being treated incorrectly because a vital piece of your medical history is missing from the one taking care of you.

OK -- my (additional) two cents!

Hugs,
Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline allopathicholistic

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Re: elective surgery and disclosure
« Reply #30 on: December 21, 2006, 11:25:17 PM »
Ifound out through trial, and error, that I shouldn't be using Biaxin because of my Trizivir.(I think it was the Trizivir, or the Viramune one) once we switched over to a different ABX I was good as new.

Lisa: Good to know! Thanks

bocker3: Great post and well worth repeating

Offline megasept

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  • Posts: 478
  • Steven here...
HIV is shameful...if we treat it that way. Disclosure is best.
« Reply #31 on: December 25, 2006, 03:32:53 AM »
HIV is shameful...if we treat it that way. Disclosure with medical and dental professionals can lead to some cool outcomes.

Years ago I had an ugly leg infection from a scratch at work that got out of control. I had hoped it would just go away. It didn't. My alarmed GP sent me right over to the ER. When an intern saw me, I reminded him of my status (they were going to lance the damn thing). He had to leave. Just then an older MD came over touched me, asked a few questions, looked me in the face, and starting working on the infection. I warned him as well (he had no gloves on). He got a little blood on his arm, and just then the intern, looking pale, ran back over warning him "You realize Doctor, he has HIV". The MD laughed and said "Yeah. I know" and kept working. I loved him for that. He taught the young fellow not to be afraid of us, not even unimportant direct contact, with our HIV-contaminated blood. I really loved that moment and the look on the intern's face. Nobody ever reads my chart; this never would have happened if I hadn't disclosed verbally twice as well. Sometimes I admit I do feel like a diseased pariah, but certainly not that day in the ER. Risk a little...gain a lot.  8) -megasept
PS Happy Chanukah, Eiad Hajj (it's soon), and Merry Xmas to...most of you; Happy and Healthy New Year to all!  ;)

Offline koi1

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  • Posts: 713
Re: elective surgery and disclosure
« Reply #32 on: December 25, 2006, 11:47:36 PM »
I was recently diagnosed with (AIDS). I had ot go to the emergency room because of a serious reaction to bactrim (med for pcp). Discolosing my HIV allowed them to give me the highest level of care. They did an MRI, Xrays, CTSCAN, urine, feces, blood, A lumbar puncture (to test for dozens of diseases that could affect the brain), and a host of other tests. Had I not told them about my status (includind cd4 and viral load), they would not have worked so hard to rule out any other opportunistic infection. They even made sure to give me a private room so as to not put me at risk for any Opportunistic infections.

 But, I do live in a big city, and the HIV is common. The nurses don't even blink. It is a part of life for them. The nurses were very compassionate and I had this feeling that they were rooting for me. Three days later, the day I got discharged, I saw one of the e-room nurses in the parking lot and she commented excitedly, "You look so much better, enjoy you holidays." She remembered me before I knew who she was.
diagnosed on 11/20/06 viral load 23,000  cd4 97    8%
01/04/07 six weeks after diagnosis vl 53,000 cd4 cd4 70    6%
Began sustiva truvada 01/04/07
newest labs  drawn on 01/15/07  vl 1,100    cd4 119    7%
Drawn 02/10/07
cd4=160 viral load= 131 percentage= 8%
New labs 3/10/07 (two months on sustiva truvada
cd4 count 292  percentage 14 viral load undetectable

Offline MitchMiller

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Re: elective surgery and disclosure
« Reply #33 on: December 26, 2006, 10:19:41 PM »
I am amazed, given all the responses, that nobody cautioned you to check the laws in your state to determine if you might be liable to arrest if you don't disclose. 
I live on a small blue island in a sea of crimson red (atlanta)... so, not surprising for the deep south,  the laws of GA mandate you must disclose.  Otherwise, you are liable for arrest under the charge of reckless endangerment (I think that would be the charge).  In fact, in GA, when it comes to sex, even if an HIV+ person discloses to an HIV- person who then willingly has sexual relations, the HIV+ person is still liable to be charged for the crime of reckless endangerment.

Offline jack

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  • fomerly the loser known as Jake
Re: elective surgery and disclosure
« Reply #34 on: December 27, 2006, 06:08:16 AM »
disclose and if they have a problem with it,you dont want them as a doctor. I live in an area 20 miles from Houston. I go into the big city for all medical stuff. Its a whole different world.

 


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