Second Lab Results, Should I be happy, worried or confused?

[Newguy]

Hi All

I hope all is well with everyone. Today was one of the most anxious days of my life so far. I move to another city on Monday to start a grad program so I am preparing for that and I had to go pick up my second lab results today. First off, my syphilis titre came back negative. 6 months ago I received one shot of penicillin instead ofd the standard three weekly shots, so this was obviously a happy moment. However my CD4 numbers were lower than before. In June my CD4 was 400 and today they came back 330. However my viral load and CD4% were identical at 36 000 and 21% respectively. He gave me a prescription for Truvada and Issentress which I will start as soon as my benefits kick in about one month. Should I be worried about the low CD4? My doctor was not concerned at all. The percentage is unchanged at 21% How can this be when the CD4 value decreased?

Best

[WillyWump]

The percentage is unchanged at 21% How can this be when the CD4 value decreased?

Best

Your CD4's can fluctuate up and down throughout the day, or even throughout the hour. But your percentage will not fluctuate that quickly. That and the difference between 400 and 330 is insignificant. So your basically the 2 readings are the same.

You should not be concerned in the least bit.

-Will

[Newguy]

Thanks for your reply Willy

Oh my god what a roller coaster! I hope this gets easier or else I have no idea how I can live like this. Every time I go to the clinic I get serious anxiety, even the personnel are really kind. Since I like my doctor I do not want to find a new one when I move next week, so he just gave me a bunch of lab forms and every three months I draw blood. If there is any problem he will call me so this way it alleviates some of the anxiety.

[JessieJames]

my last three test varied by 80 points.  Don't sweat it.  You will start to get used to getting your labs back.  I sometimes forget that I had my labs done in the morning and I am surprised when the doctor calls me. 

I used to freak out from test to test. But after a while, it becomes routine.   

So, to answer your questions, you should be happy! 

[Cojo]

Hey Newguy,

I empathize with you indeed. I have found the toughest part of this HIV journey to be the anxiety around labs. Ironically, if you look at my tag line, my lastest CD4's dropped from 400 to 330 as well!
With impending labs in two weeks, this is what I am trying to do to keep my head sane.

First, to REALLY listen to the folks on here. They have been at this a long, long time and the collective wisdom is a rare and valuable gift. You will see in this and other threads that they will tell us that it is just a number and trends are what count; that a variance of +/- 100 is essentially the same number and to chill! I have really tried to focus on that.

Secondly, I am trying to think in ranges, not numbers. I think since grade 1 we are trained to think that 90 is better than 85, 85 better than 80, 80 better than 75 and so on. We think in linear absolutes. With CD4 counts, we need to think in chunks or segments that represent ranges (king of grading in A,B,C,D etc). So I think of 300-500 as a B+, not quite the clinical normal, but almost there. I hope to get an A in a few weeks, but I'll let you know

Hope this reference point makes sense and helps.

[JessieJames]

Once you start accumulating tests you anxiety will decrease.  I have been using the Graph My Labs feature on this site since 2003. 

Whenever I get a bit worried, I look at the trends over the last 9 years and it all my anxiety dissipates. 

You can't control your numbers---and they are only numbers---but you can control your adherence to your ARV. 

I was at 25 with a viral load of 1.1 million in early 2008. I was admitted to the hospital with MDR TB and and ensuing host of OIs.   It was terrible.  I went from 180lbs to 120 lbs. 

  It took me about 12 months to begin hovering around 250.  And then after a med change, I have been hovering around 500 for the last couple years. 

I smoke two packs a day, I have substantial job stress, and I exercise irregularly.  But I don't miss my meds.  It is the most important thing you can do.  And it is something you can control. 

Do whatever you have to do to make sure you don't miss your meds.  I keep a few in my car, a few in my office, a few at my friends house, a few in my laptop bag....I have alarms set on my cell phone.