Welcome, Guest. Please login or register.
March 28, 2024, 03:08:18 pm

Login with username, password and session length


Members
Stats
  • Total Posts: 772946
  • Total Topics: 66310
  • Online Today: 424
  • Online Ever: 5484
  • (June 18, 2021, 11:15:29 pm)
Users Online
Users: 2
Guests: 351
Total: 353

Welcome


Welcome to the POZ Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Do I Have HIV?” posting guidelines. Click here for posting guidelines pertaining to all other POZ community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Less than 2 weeks since positive diagnoses  (Read 31169 times)

0 Members and 1 Guest are viewing this topic.

Offline actonye

  • Member
  • Posts: 16
Less than 2 weeks since positive diagnoses
« on: February 24, 2013, 05:12:08 am »
Hi everyone,
Not sure where to start here. After going through medical school and being a doctor for 7 years, having my family look at me as the golden child, and now to be diagnosed with hiv? I had always been the advocate for safe sex, advising all my friends and anyone who cares to listen to practice safe sex, and then I get infected, still very confused as to how it happened. My ex has refused to answer my calls since my diagnoses.
I'm so scared as to what this means for my medical careear. I live in ireland and was planning on moving to the states to continue my medical training, now that's a dream that will never happen.
I'm so worried about my future, I can't tell my parents. My consultant tells me it'll be alright, but how can I ever be alright. As another healthcare professional, I would like to talk to anyone who out there is in the same situation as me . Please I'm severely depressed and feeling really suicidal at the moment .. Not sure if life is still worth living now..

Offline tednlou2

  • Member
  • Posts: 5,730
Re: Less than 2 weeks since positive diagnoses
« Reply #1 on: February 25, 2013, 01:59:53 am »
If you are feeling suicidal, please seek care immediately.  It is cliche, but suicide is a permanent solution to a temporary problem.  Well, the virus isn't temporary, but these feelings you're having are. 

Why can't you still come to the U.S. to further your training?  HIV doesn't change that.  Do you not have a friend to confide in?  Keep in touch here.  As a doctor, suicide would send the message that if you are infected with a virus or ill with something, then why try to live and get medical treatment?  You may as well just kill yourself.  I know you don't want to give that message.  Obviously, someone considering suicide isn't thinking clearly.  But, put that medical training to work.  See someone for your depression. 

I think from what you said, you have so many expectations on your shoulders.  This is the mistake many parents make.  It is good to be proud of your child, but don't make them feel that they have to be 100% perfect.  Many professionals, like medical students, do commit suicide in large numbers, because so much is expected of them. 

I hope to hear that you have sought out treatment for the depression.  Do this tomorrow, please.  Actually, in Ireland, the sun should be up soon.  There are other medical professionals here.  Actually, one just made a post looking for other med professionals. 

Things will get better.  Keep in touch. 

Ted


Offline Souledout

  • Member
  • Posts: 160
Re: Less than 2 weeks since positive diagnoses
« Reply #2 on: February 25, 2013, 03:51:04 pm »
I'm quite new to this too so I can easily remember the world shattering impact of the diagnosis. I can tell you that it gets easier, now HIV only occupies about half my thoughts ;) I echo the post above about seeking help, there will be some available (although I'm still waiting on counselling and I was diagnosed in September.a right ballache that I can tel you).

I also completely share your confusion about how you got it. I played safe 100% of the time for anything other than oral sex, must've been some tiny break I missed. Some people are just unlucky I guess. Very unlucky.

If you're completely isolated, come to Manchester, we'll have a beer. I don't know any other positive people so I'm kinda feeling a bit cut off myself.

And remember - it does get easier, don't do anything rash. You'll get through it and it'll make you far stronger than you could possibly imagine :)
Infection sometime April-August, no noticable seroconversion symptoms
Not currently on medication
13/09/12 CD4 672 (33%) VL <40 (diagnosis date)
18/09/12 CD4 ?               VL 43
27/09/12 CD4 ?               VL 127
19/11/12 CD4 676 (38%) VL 959
03/03/13 CD4 642 (32%) VL 291
04/07/13 CD4 791 (33%) VL 26,437 (active cold sore, tooth infection)
18/07/13 ------retest------VL 3704
18/11/13 CD4 802 (36%) VL 65

Offline Danigirl

  • Member
  • Posts: 14
Re: Less than 2 weeks since positive diagnoses
« Reply #3 on: February 25, 2013, 03:58:54 pm »
Hello Actonye,

I'm sorry to hear that you tested positive, I know how devastating it feels when you are first diagnosed.  My husband just tested positive last month...me...negative so far.  Apparently, he has had it for years without knowing. 

We are both in the medical field.  My main concern was his exposure to sick patients and him getting sick. Working in a hospital as you probably already know, sometimes patients come in for one thing and you come back the next day and that patient is in isolation after you worked with them all shift the day before.  So, I was concerned about his exposure while having an already compromised immune system.  In the beginning we even played with the idea of him switching professions.  After informing ourselves further on HIV we decided that it is not necessary.  As long as he takes his medication and eats healthy, exercise, etc. everything should be fine.  Besides, he loves what he does way too much to quit. 

I know it is a lot to take in but you are not by any means alone.  There are plenty of people in the medical field who are HIV+ as well.  Your life is NOT over! What you have is a chronic condition that can be managed not a death sentence.  Furthermore, you do not have to disclose your status to anyone unless you want to so that is not an issue. 

Please seek help if you are feeling suicidal. You can get through this!

Offline mecch

  • Member
  • Posts: 13,455
  • red pill? or blue pill?
Re: Less than 2 weeks since positive diagnoses
« Reply #4 on: February 25, 2013, 07:26:10 pm »
actonye

I asked some questions after your post in the thread about Health professionals with HIV.

Now I see the answers here.

You are all topsy turvy from this shocking diagnosis.  However, keep in mind, you are not going to die. And you do have legal protections in Ireland against employment discrimination for HIV, which is considered a disability.

You can inform yourself of your rights, here:
http://www.equality.ie/en/Contact-Us/

I realise just because the law protects against discrimination, that it doesn't always shake out so lollipop perfect in reality...  But still....

Seems like you should contact an HIV / aids service organisation, such as the one in Dublin,
http://www.dublinaidsalliance.ie/index.php?page=community-support

or, in fact, ANY kind of social service / crisis center that can offer you a discrete and professional person to talk to about some of your distraught emotions. 

You have a right to all your feelings - but you really need to address this extreme shame and disappointment in yourself, and quickly. 

Since you are a doctor, you know that your diagnosis is not a death sentence, but for the moment, you seemed overwhelmed by this heaping dose of reality - in the form of bad news - slamming against an image you have created for yourself, and one which perhaps others foisted upon you.

Time to shove all that "how it should be" off your shoulders and just deal with the reality.  You'll be more powerful, more your true self, and more grounded when all is said and done...

And, there is no reason you can't still be the "golden boy" with HIV.  You got your career, your mind, your ambition, please don't throw it away cause of some temporary emotional crisis.  Or how others might view you.  Or shame..


“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #5 on: February 26, 2013, 07:01:41 am »
Hallo to everyone Out there. Just tester positive yesterday on the quicktest. My partner of four years had some flu-like symptoms and I got worried cause I had a slip three months ago. I am a doctor, a surgeon actually. Thought this was all out of my world. People, I live Alone in a Western European country , my family thousands of miles away. All by myself. No friends. My partner is four hours away, so we see each other every weekend or two.
I cannot describe the amount of despair I am feeling. The amount of pain and fear. I will probably lose my job, since surgeons with hiv are considered a hospital liability. The will not fire me, but I will never operate again. If my bf tests positive too, then who knows if he is going to support me in the long run? For know he is a rock beside me..
I learned of the diagnosis being in a foreign country, need to get back home to see what can do with mess and stuff. I have reached my human endurance. I am afraid as I have never been. I feel guilt and remorse and pain and fear and desperation....
« Last Edit: February 26, 2013, 07:03:36 am by Lumpy »

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #6 on: February 26, 2013, 07:08:15 am »
Hi Lumpy, welcome to the forums.

You say you tested positive on a rapid test. Rapid tests sometimes return FALSE positive results. This means that you MUST have further testing done.

You should have a blood test done to look for antibodies and if this is also positive, then the result MUST be confirmed with a Western Blot test.

Please understand that you are not considered to have been diagnosed as hiv positive until such time as you have had the confirmatory test done and they are also positive.

False positive results can and do happen (pregnancy and autoimmune disease can cause them - and sometimes they just happen) so you absolutely do need to have the confirmatory tests run.

Good luck - and hang in there in the meantime.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #7 on: February 26, 2013, 07:24:59 am »
Thank you for your kind words. But I read these are 99% positive. And it will not be false positive o,n a gay man.... I have to be realistic. I am expecting the second test in a few hours.. It's just that I'm such agony and pain.... And unfortunately alone Ina foreign country

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #8 on: February 26, 2013, 08:03:26 am »

And it will not be false positive o,n a gay man.


False positive results can and do happen to gay men all the time. The test doesn't know your sexual orientation and being gay does not automatically mean you're going to end up with hiv.

ANYONE who has had a preliminary positive test result MUST have that result confirmed - or ruled out - with further testing.
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline actonye

  • Member
  • Posts: 16
Re: Less than 2 weeks since positive diagnoses
« Reply #9 on: February 26, 2013, 08:07:17 am »
To everyone who replied to my dilemma thank you all so much. I have all the facts at my fingertips. I know what will happen. It's just I still feel cheated my life. I spent my first year as an intern looking after hiv positive patients. I feel an incredible amount if fear because I saw a few of them die. Now their situation was different to mine in the sense they were not on treatment till it got too late.
I worry about my family. Just like lumpy my family are miles away from me. I worry about what this will do to them. It's in my nature to worry about others. I want to be strong and move on from here, but just not sure how. I've taken all the right steps seeing a counsellor, getting all the necessary investigations done, but I feel like the old me has died and now I have a new me with so many challenges to face. This forum has really helped and you guys are really amazing for taking time out to reassure me. I'm almost crying at work writing this. I look forward to smiling again. I don't know if that will happen. I really hope it does. I can't get myself to look at my old pictures without crying. I really hope this gets easier. I mourn my life even though I'm still alive. What next?

Offline Common_ground

  • Member
  • Posts: 292
Re: Less than 2 weeks since positive diagnoses
« Reply #10 on: February 26, 2013, 08:31:45 am »
Just want to give you some reassurance. I also tested positive in a foreign country and continent, in a totally different culture than my own far away from family and friends. First time was ROUGH, I mean like hardship I never faced before. But with time it slowly got better, and a part of that was these forums, knowledge is power!

I really do understand what you feel like and the thoughts running through your head at this time, but believe and take comfort in that you will get through this and come out more than ok :)   
2011 May - Neg.
2012 June CD4:205, 16% VL:2676 Start Truvada/Stocrin
2012 July  CD4:234, 18% VL:88
2012 Sep  CD4:238, 17% VL:UD
2013 Feb  CD4:257, 24% VL:UD -viramune/truvada
2013 May CD4:276, 26% VL:UD

2015 CD4: 240 , 28% VL:UD - Triumeq
2015 March CD4: 350 VL: UD

Offline mecch

  • Member
  • Posts: 13,455
  • red pill? or blue pill?
Re: Less than 2 weeks since positive diagnoses
« Reply #11 on: February 26, 2013, 08:51:50 am »
Yes, you can imagine how your family will take the news and react to the "new you".  Based on your family history, or your culture. But, please don't bet on being right... Families are surprising.  Also, sometimes they say one thing, publicly, in accord with cultural norms or family tradition, then act differently in private...  Right?

Concentrate on yourself, and accepting yourself, and put all the family stuff on the back burner if you can.  This might not seem natural, to you, I dunno.  This insistence on the individual.  But you don't necessarily have to disclose to them now..  All in good time.

When you feel strong and accepting about yourself, this might make a difference in how your family perceives the news, anyway.  People do feed off others energy. 

That said, a good rule for living well with HIV is to evacuate ALL shame about the disease from one's own mind.  Other people's reactions are their shit, their problem.  Yeah, they can make it difficult for us.  Or, they might not... But its ALL their shit.  Even if its family. Even if its loved ones. Even if you think you have responsibilities to them, whatever they are.  Its all their shit, and you are responsible only to yourself and you can make yourself happy, content, successful, and healthy.

I realise not all cultures nor all family traditions leave a lot of room for individual destiny.  But if, god forbid, worst case scenario, your family were to judge you or make something needlessly difficult, a concentration on the individual would be the route to successful living. And they might not react the way you are expecting, anyway. 
« Last Edit: February 26, 2013, 09:18:53 am by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Dachshund

  • Member
  • Posts: 6,058
Re: Less than 2 weeks since positive diagnoses
« Reply #12 on: February 26, 2013, 09:29:24 am »
False positive results can and do happen to gay men all the time. The test doesn't know your sexual orientation and being gay does not automatically mean you're going to end up with hiv.

ANYONE who has had a preliminary positive test result MUST have that result confirmed - or ruled out - with further testing.

this^

Offline Souledout

  • Member
  • Posts: 160
Re: Less than 2 weeks since positive diagnoses
« Reply #13 on: February 26, 2013, 06:43:06 pm »
Actonye, you will smile again. Believe me.

Do you have a support network in place? Not family obviously (if you want they need never know, at at least not until you're ready to tell them) but a few good friends. They'll make all the difference and will help you rebuild your confidence.

I get what you say about mourning, I went through similar, it was hard. But like you will, I got there (am getting maybe?). What's life without a bit of a challenge hey?



Infection sometime April-August, no noticable seroconversion symptoms
Not currently on medication
13/09/12 CD4 672 (33%) VL <40 (diagnosis date)
18/09/12 CD4 ?               VL 43
27/09/12 CD4 ?               VL 127
19/11/12 CD4 676 (38%) VL 959
03/03/13 CD4 642 (32%) VL 291
04/07/13 CD4 791 (33%) VL 26,437 (active cold sore, tooth infection)
18/07/13 ------retest------VL 3704
18/11/13 CD4 802 (36%) VL 65

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #14 on: February 28, 2013, 06:42:04 am »
This is My third Day after the diagnosis. I try very hard to eat something and drink some water. I still cannot breath normally and sleeping pills help just for a few hours. I am in a foreign country, away from home, but here is where my bf is and we need to stick together. My worst fear is not only  how this will affect my relationship, but also my job. I am a surgeon  you see . And this is all I have Been since I graduated high-school. In Germany where I live, it is very complex. I need to see a lawyer about this.
Right now I just wish the pain would subside just a little, so that a can take a whole breath or that I can move myself to the kitchen. I am so alone. So afraid.

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #15 on: February 28, 2013, 09:34:52 am »

This is My third Day after the diagnosis.


Lumpy, have you had the Western Blot run yet? You absolutely CANNOT consider yourself to be hiv positive until such time as you've had this confirmation.

You're a surgeon - would you go ahead and remove someone's appendix (for example) before making absolutely sure that the appendix needs to be removed? I sure hope you wouldn't. This is a similar situation. You may be getting all worked up over a test result that may turn out to be a false alarm.

Until you've had your rapid positive test result confirmed with further testing, I need to ask you to only post in this thread. Thank you for your cooperation.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #16 on: February 28, 2013, 10:53:40 am »
Yes. It is confirmed

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Less than 2 weeks since positive diagnoses
« Reply #17 on: February 28, 2013, 10:47:09 pm »
Yes. It is confirmed

With a blood test and western blot? Wow! I really had no idea that the turnaround for those tests could be so fast. I suppose being a surgeon, you have access to testing procedures that us laymen do not.

I am very sorry you tested positive. When will you be getting your labs done to ascertain your cd4 count, viral load, and percentages?

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline aaware72

  • Member
  • Posts: 226
Re: Less than 2 weeks since positive diagnoses
« Reply #18 on: February 28, 2013, 11:02:35 pm »
With a blood test and western blot? Wow! I really had no idea that the turnaround for those tests could be so fast.

Really?  I'm just an unemployed full time student.  I received back these result in 1 week.  Is this uncommon?  I get my care here: http://www.massgeneral.org/infectiousdisease/
"Yes, knowledge is power. Self-knowledge brings mastery of one's body."

Offline Jeff G

  • Administrator
  • Member
  • Posts: 17,064
  • How am I doing Beren ?
Re: Less than 2 weeks since positive diagnoses
« Reply #19 on: February 28, 2013, 11:15:41 pm »
Really?  I'm just an unemployed full time student.  I received back these result in 1 week.  Is this uncommon?  I get my care here: http://www.massgeneral.org/infectiousdisease/


Yes ,,, that's lighting fast for these kind of test to be processed . I have never heard of a 3 day turnaround on a western blot test before like Lumpy is claiming .
HIV 101 - Basics
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Less than 2 weeks since positive diagnoses
« Reply #20 on: February 28, 2013, 11:40:41 pm »
Really?  I'm just an unemployed full time student.  I received back these result in 1 week.  Is this uncommon?  I get my care here: http://www.massgeneral.org/infectiousdisease/


That is truly astonishingly fast healthcare. In most of the US a two-week turnaround is expected for Western Blot tests, which are normally NEVER done "in house" like other tests.

For example, I can get my cd4 test results in days, but my viral load often takes ten business days or more since they have to send it out.

Guys, count yourselves lucky that you live where you do.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline texaninnyc87

  • Member
  • Posts: 251
Re: Less than 2 weeks since positive diagnoses
« Reply #21 on: February 28, 2013, 11:43:48 pm »
I live in NYC so things are probably a little more speedy here. Still, I think my western blot took 2 weeks. My cd4/vl labs take one week.
Dxd: 9/11/12
Blot confirmed: 11/12
12/12 cd4: 280 (20%) vl: 129,000
1/13 $tribild
2/13 cd4: 350 (26%) vl: 80
4/13 cd4: 510 (29%) vl:: 35
6/13cd4 350 (31%) vl: 21
9/13 cd4 492 (30%) vl: ud
12/13 cd4 846 (36%) vl: 100
1/14 cd4 480 (31%) vl: UD
3/14 cd4 650 (33%) vl: UD
6/14 cd4 410 (35%) vl: UD
9/14 cd4 439 (38%) vl: UD
12/14 cd4 551 (37%) vl: UD

Offline Miss Philicia

  • Member
  • Posts: 24,793
  • celebrity poster, faker & poser
Re: Less than 2 weeks since positive diagnoses
« Reply #22 on: February 28, 2013, 11:50:04 pm »

For example, I can get my cd4 test results in days, but my viral load often takes ten business days or more since they have to send it out.

Really? Mine take 2 days, sometimes 3 at most. And yes it's sent out to a lab 70 miles away.
"I’ve slept with enough men to know that I’m not gay"

Offline Jeff G

  • Administrator
  • Member
  • Posts: 17,064
  • How am I doing Beren ?
Re: Less than 2 weeks since positive diagnoses
« Reply #23 on: March 01, 2013, 12:00:33 am »
It always takes at least a week to 10 days for my viral load to come back .
HIV 101 - Basics
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline aaware72

  • Member
  • Posts: 226
Re: Less than 2 weeks since positive diagnoses
« Reply #24 on: March 01, 2013, 12:01:21 am »
That is truly astonishingly fast healthcare. In most of the US a two-week turnaround is expected for Western Blot tests, which are normally NEVER done "in house" like other tests.

For example, I can get my cd4 test results in days, but my viral load often takes ten business days or more since they have to send it out.

Guys, count yourselves lucky that you live where you do.

I had blood work done yesterday afternoon and I have my CD4 count about the same time today.  I know the last time they did bloods my VL was back in less than a week. 

I'm getting services in Boston at Massachusetts General Hospital.  I know they do a lot studies and trials there.  I'm actual a subject in a study on "The acute and early cohort of HIV infected individuals.  They validate my parking and pay me $20.00 each visit so it covers my expense to travel into the city.  The study also covers the cost of the drugs if needed. I'm very happy so far with what I have been experiencing.  I guess I should consider myself lucky then. 
"Yes, knowledge is power. Self-knowledge brings mastery of one's body."

Offline tednlou2

  • Member
  • Posts: 5,730
Re: Less than 2 weeks since positive diagnoses
« Reply #25 on: March 01, 2013, 12:35:10 am »
They always told me it takes anywhere between 2-3 weeks to get back labs.  So, I was surprised everything was back by last Friday.  I did the blood work last Tuesday.  It may have been back Thursday.  A two day turnaround.  Everything was back, including my lipids, STD screen, Hep B titer, and Vit D, as well as the regular CD4, vl, and metabolic.  I think they must just tell people to give 2-3 weeks before an appt, just in case.  Or, they have gotten faster. 

They did put a blood draw room in the office, but I don't see what that would change as far as processing. 

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Less than 2 weeks since positive diagnoses
« Reply #26 on: March 01, 2013, 12:43:00 am »
I had blood work done yesterday afternoon and I have my CD4 count about the same time today.  I know the last time they did bloods my VL was back in less than a week. 

I'm getting services in Boston at Massachusetts General Hospital.  I know they do a lot studies and trials there.  I'm actual a subject in a study on "The acute and early cohort of HIV infected individuals.  They validate my parking and pay me $20.00 each visit so it covers my expense to travel into the city.  The study also covers the cost of the drugs if needed. I'm very happy so far with what I have been experiencing.  I guess I should consider myself lucky then. 

You probably know this, but you live in a state (so far as I know the ONLY STATE) whose HIV testing is so well funded that six weeks, rather than the global two-month standard, is considered a definitive HIV test.

Which I find amazing.

(also infuriating as I want it to be implemented worldwide)
"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #27 on: March 01, 2013, 05:38:38 am »
Cd4 and viral load will take longer. Just had western blot and elisa. Don't forget guys I am in a foreign country now, Switzerland , just visiting my boyfriend. We found out together. His cell counts , resistance etc will come in 10 days but I have to wait to get back in Germany where I live.
But guys I have one HUGE problem that u don't. I am a surgeon and right now I don't know if I Can work anymore. To be a surgeon I have sacrificed my entire life. And this life is now over. I am so afraid and in so much pain I can hardly breathe. It's been three days since the diagnosis and I can still not drink or eat. When will the pain go away??? Will I ever be happy again ? My bf at least is supportive. I know u are all going through the same ordeal. It's just that I have a long distance relationship which will take a lot of beating now and that I might soon not have a job ...
Please, any kind words will help

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #28 on: March 01, 2013, 06:34:02 am »
I was tested for hiv because I was a "named contact" of someone who had tested positive.

I was summoned to the clinic on a Tuesday and they did a blood draw for an ELISA. I went back the next day and was told I tested "preliminary" positive and they took more blood, for a second ELISA plus a Western Blot.

I went back the following day (Thursday) and they had the results for both the second ELISA and the Western Blot. Both positive. So it was only 48 hours between the initial blood draw and being confirmed as hiv positive.

My situation may have been a little different to the norm because the clinic where I live was dealing with a large (a couple hundred) group of people who had all been named contacts of two or three people who had tested positive in a small community.

They were rushing ELISA and WB tests through their lab in an attempt to contain the "cluster of infections", as they called it. In the end there were eight of us who were diagnosed as a result of this "cluster".

VL results always take around ten working days (ie Monday through Friday) to come back.

Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #29 on: March 01, 2013, 06:36:54 am »

I am a surgeon and right now I don't know if I Can work anymore. To be a surgeon I have sacrificed my entire life.


Surely you can change to a different speciality?

Surgeons have to step down for all sorts of reasons and many of them go into a different field of medicine. How about becoming an hiv specialist, for example?

You don't have to give up on the practice of medicine completely just because of hiv. There are plenty of hiv positive health care professionals out there - you can be one too.

And yes, it does get better. Your life with hiv will be what you make of it, just like your life would have been what you make of it without hiv.

Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #30 on: March 01, 2013, 06:48:49 am »

I am a surgeon and right now I don't know if I Can work anymore. To be a surgeon I have sacrificed my entire life.


Also, you may find that you don't actually have to stop being a surgeon.

http://www.thebody.com/Forums/AIDS/Spiritual/Q10161.html?ic=2003

http://www.channel4.com/news/government-plans-end-to-ban-on-hiv-positive-surgeons

I suggest you google "hiv positive surgeons" (include the quote marks) and read some of the hits you get - but make sure they're from at least 2010 onwards. Don't bother reading things from the 1980s, 90's or early 2000s. Read recent articles.

Being able to perform surgery may be dependant on being on meds and having an undetectable viral load, but attitudes are definitely changing away from the blanket ban on health care professionals performing invasive procedures.

I think you need to take some time to absorb the whole idea of being hiv positive, and then start researching exactly what the deal is where you live. Things are not as dire as you are imagining.

Hang in there, you're ultimately going to be ok.

Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline umfowabo

  • Member
  • Posts: 36
Re: Less than 2 weeks since positive diagnoses
« Reply #31 on: March 01, 2013, 07:02:02 am »
I don't know if this helps you Lumpy or anyone else but I think you can still work as a surgeon in Germany.Last year the German Association for the Control of Viral Diseases (DVV) and the Society for Virology (GfV) made guidelines about healthcare workers with HIV and it looks like it might not be a problem as long as you follow certain procedures.There is a summary about it here http://www.ncbi.nlm.nih.gov/pubmed/22842887

if you only speak German then the same summary is on this website http://link.springer.com/article/10.1007%2Fs00103-012-1546-8

Obviously you need to check that is correct though with the Health Ministry or  an employment lawyer though.
(sorry if I wasn't allowed to post this here I just thought it might help him)

Matthew

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #32 on: March 01, 2013, 07:28:37 am »

(sorry if I wasn't allowed to post this here I just thought it might help him)

Matthew

No problem, Matthew. Nice to "see" you and I hope you're doing well. I think of you (and Kate) often.

Hugs,
Ann
xxx
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #33 on: March 01, 2013, 09:05:57 am »
Tank you so much for that Post Matthew. It gives me hope. It is good to see people care. God bless you
Thank you so very much

Offline YellowFever

  • Member
  • Posts: 172
Re: Less than 2 weeks since positive diagnoses
« Reply #34 on: March 01, 2013, 01:47:07 pm »
At the very least, you can still operate on 34 million people worldwide. Doctors without borders might want you...If you do plastic surgery, some people here might want your help with lipodystrophy. I'm not in a position to give career advice here...just lightening up the mood.  :P
08/2010 HIV- 08/2012 HIV+
10/2012 CD4 415
04/2013 CD4 457
10/2013 CD4 520 VL 650
02/2014 CD4 410 VL 390
08/2014 CD4 580
01/2015 CD4 500 VL UD
05/2015 CD4 420 VL 2500
08/2015 CD4 460 VL UD
03/2016 CD4 500 VL UD
08/2016 CD4 410 VL 4467

Offline pittman

  • Member
  • Posts: 286
Re: Less than 2 weeks since positive diagnoses
« Reply #35 on: March 02, 2013, 12:11:27 am »
Sorry to hear you guys tested positive. I am sure being in the medical profession can add a whole other emotional aspect to the diagnoses.

At the web site www.thebody.com, there are several doctors that managed the "ask the expert" columns and post in the forums. Some of them are also HIV positive. You may want to check it out and perhaps reach out there as well.

While I am not familiar with the various laws or restrictions,that may be in place for HIV+ medical professionals, its only seems logical to me that the universal precautions used should be effective both ways, protecting both the medical practitioner as well as the patient.  I would explore options before making any assumptions. Perhaps this won't force you to change careers or plans to the degree you think.

Even if it does, the worst case may be that you adjust your career path to some other specialty as countless people do all the time for a wide number of reasons.

Right now is probably one of the most stressful and emotional parts of dealing with being HIV+, but like so many say, it really will get MUCH easier to deal with and you may come through the experience with new perspectives that change what you actually want to do anyway.

Offline CLP1972

  • Member
  • Posts: 12
Re: Less than 2 weeks since positive diagnoses
« Reply #36 on: March 02, 2013, 04:12:10 am »
I, too, am a physician living with HIV.  You all are NOT alone.  It appears, from reading other posts, that the discrimination directed towards medical professionals is decreasing in Europe.  Unfortunately, we have a way to go in the U.S., as there is no federal regulation and each state can make up their own rules.  Some states only require you report your status if you have a potential exposure, while other states require that you advertise your status in written form, so that all potential patients will have the choice of whether they still want to see you, after learning of your status.  For most of us, medicine and helping others, is a calling in life.  This calling often causes us to sacrifice 1/3 of our life in school and then leaves us about $200,000 in debt.  One study noted that, if a patient knew their doctor was poz, only 30% of people would want to see him/hr.  With threats of losing our jobs, or losing patients, which would essentially cause us to lose our job, how would we ever even be able to repay our loans?  Not to mention, helping people is what drives me to live everyday...take that away, and I'm a broken man...even more than I was when first diagnosed.  Only with education can we change this.  It's time to stand up and say that we are here, and the laws must change!  Lumpy, please send me a private message and we can talk more.  Take care!

Offline CLP1972

  • Member
  • Posts: 12
Re: Less than 2 weeks since positive diagnoses
« Reply #37 on: March 02, 2013, 04:14:49 am »
Oh, and in regard to testing and turnaround times for tests, a Western Blot is a 1-day turnaround, Viral Load/CD4 is 3 days where I live.  So, yes it is possible to get labs back that quick...all depends on the area, and to which lab the bloodwork is sent.

Offline Souledout

  • Member
  • Posts: 160
Re: Less than 2 weeks since positive diagnoses
« Reply #38 on: March 02, 2013, 04:40:19 am »
Could you work with people with HIV? I'm sure they wouldn't mind one little but, in fact it could be a plus. Or am I being a bit simplistic as I have no idea what retraining would involve.
Infection sometime April-August, no noticable seroconversion symptoms
Not currently on medication
13/09/12 CD4 672 (33%) VL <40 (diagnosis date)
18/09/12 CD4 ?               VL 43
27/09/12 CD4 ?               VL 127
19/11/12 CD4 676 (38%) VL 959
03/03/13 CD4 642 (32%) VL 291
04/07/13 CD4 791 (33%) VL 26,437 (active cold sore, tooth infection)
18/07/13 ------retest------VL 3704
18/11/13 CD4 802 (36%) VL 65

Offline Lumpy

  • Member
  • Posts: 7
Re: Less than 2 weeks since positive diagnoses
« Reply #39 on: March 02, 2013, 05:38:34 am »
I am a Cardiac surgeon. I have sacrificed all my life to be that. Not to practice what I learned my whole life would be worse than the diagnosis

Offline Souledout

  • Member
  • Posts: 160
Re: Less than 2 weeks since positive diagnoses
« Reply #40 on: March 02, 2013, 06:30:40 am »
Well if it turns out you can't do that you'll have to find something else to do for a living... And I'm sure that brilliant mind, skill set and desire to help people could be put to fantastic, very fulfilling, use.
Infection sometime April-August, no noticable seroconversion symptoms
Not currently on medication
13/09/12 CD4 672 (33%) VL <40 (diagnosis date)
18/09/12 CD4 ?               VL 43
27/09/12 CD4 ?               VL 127
19/11/12 CD4 676 (38%) VL 959
03/03/13 CD4 642 (32%) VL 291
04/07/13 CD4 791 (33%) VL 26,437 (active cold sore, tooth infection)
18/07/13 ------retest------VL 3704
18/11/13 CD4 802 (36%) VL 65

Offline Whymeh

  • Member
  • Posts: 8
Re: Less than 2 weeks since positive diagnoses
« Reply #41 on: March 03, 2013, 05:28:24 pm »
Its been nearly 4 weeks since i tested positive and since then my life has felt like a nightmare. As a health professional i feel so irresponsible and stupid for having contracted this. I feel like All my goals and dreams have been pulled out from under me  and cannot fathom why. I live in a small town in Ireland and the stigma is another issue that worries me.
I am trying to move on with my life as much as i can although the first week i just wanted to die...every time i went for a drive i hoped i would die in some accident. Right now i am trying to be as positive as possible and knowing that this MUST have happened for a reason...that reason i dont know right now but it keeps me going...talking to docs infact anyone who i can confide in really helps

Hope you can learn to deal with this....you can still live a normal life....just find a way to try and cope with this massive blow.
Peace out

Offline pittman

  • Member
  • Posts: 286
Re: Less than 2 weeks since positive diagnoses
« Reply #42 on: March 04, 2013, 11:11:12 pm »
Its been nearly 4 weeks since i tested positive and since then my life has felt like a nightmare. As a health professional i feel so irresponsible and stupid for having contracted this. I feel like All my goals and dreams have been pulled out from under me  and cannot fathom why. I live in a small town in Ireland and the stigma is another issue that worries me.

I certainly can relate as many do to the feelings. But I also try to keep it in perspective. I think that at the heart of the matter is sex, and our feelings around it.  The majority of people with HIV get it through sex, and sex is still more taboo than we often admit.

So try a thought experiment, and imagine that instead of HIV you were diagnosed with some other condition with some other cause-- diabetes linked to your weight, skin cancer due to over tanning, lung cancer due to smoking.  Know any doctors that smoke, or who fail to eat healthy and exercise?  Would you have the same emotional reaction, or to the same degree, if they had a sexually transmitted disease?

While this is all pretty obvious, I think it is worth reminding ourselves.  Many, many people do things that are not good for them, and that includes doctors. It is the sexual aspect (and the gay association) that brings the stigma. I just don't think it is logical to think people are more at fault for sexual diseases than they are for other conditions that can be linked to behaviors. 

You can't count on others to always be rational, so you might as well start playing that role yourself and stop beating up yourself over it.  I wish you the best in your care and hope that you find your way through this and that you allow yourself some compassion.
« Last Edit: March 04, 2013, 11:17:51 pm by pittman »

Offline mecch

  • Member
  • Posts: 13,455
  • red pill? or blue pill?
Re: Less than 2 weeks since positive diagnoses
« Reply #43 on: March 05, 2013, 09:00:12 am »
I certainly can relate as many do to the feelings. But I also try to keep it in perspective. I think that at the heart of the matter is sex, and our feelings around it.  The majority of people with HIV get it through sex, and sex is still more taboo than we often admit.

So try a thought experiment, and imagine that instead of HIV you were diagnosed with some other condition with some other cause-- diabetes linked to your weight, skin cancer due to over tanning, lung cancer due to smoking.  Know any doctors that smoke, or who fail to eat healthy and exercise?  Would you have the same emotional reaction, or to the same degree, if they had a sexually transmitted disease?

While this is all pretty obvious, I think it is worth reminding ourselves.  Many, many people do things that are not good for them, and that includes doctors. It is the sexual aspect (and the gay association) that brings the stigma. I just don't think it is logical to think people are more at fault for sexual diseases than they are for other conditions that can be linked to behaviors. 

You can't count on others to always be rational, so you might as well start playing that role yourself and stop beating up yourself over it.  I wish you the best in your care and hope that you find your way through this and that you allow yourself some compassion.

Wow that is so true, and so well said.

I think what Ann said is quite constructive - we all have to inform ourselves of any possible restrictions to our rights, be they rights at work, socially, sexually...  Its so common to have many fears about this aspect of living with HIV --- discrimination and legality, etc. etc., ---  so its important to find out exactly WHICH things apply to one's own situation, and which do not. 
« Last Edit: March 05, 2013, 09:05:28 am by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline actonye

  • Member
  • Posts: 16
Re: Less than 2 weeks since positive diagnoses
« Reply #44 on: March 05, 2013, 01:36:53 pm »
I just had to tell my bosses at work that I'm positive. Seeing as I perform chest drains as part of my job in the Ed. I am now not allowed to perform any more exposure prone procedures. I don't know what to do now. I can't even go back into work. The shame is killing me. I'm so ashamed of myself. I don't want to go on living. Now every new job as part of my training I need to let a senior doctor know so I can be excluded from that one function.
My life has just become a whole lot more difficult.
I'm not sure where to go from here.

Offline Jeff G

  • Administrator
  • Member
  • Posts: 17,064
  • How am I doing Beren ?
Re: Less than 2 weeks since positive diagnoses
« Reply #45 on: March 05, 2013, 01:46:04 pm »
I just had to tell my bosses at work that I'm positive. Seeing as I perform chest drains as part of my job in the Ed. I am now not allowed to perform any more exposure prone procedures. I don't know what to do now. I can't even go back into work. The shame is killing me. I'm so ashamed of myself. I don't want to go on living. Now every new job as part of my training I need to let a senior doctor know so I can be excluded from that one function.
My life has just become a whole lot more difficult.
I'm not sure where to go from here.

Things may be changing for you but its not the end of the road . It gets better in time .
Many of us that are HIV positive have had to alter our lives and make changes accordingly to accommodate living a full life despite HIV , you can do this too in time .

If one of your patients faces an illness and they feel life is over and they cant adjust in a psychological healthy way , what would you advise them to do ? I think you know what I'm suggesting and that's get the help you need , make a new plan and make it happen .
HIV 101 - Basics
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Less than 2 weeks since positive diagnoses
« Reply #46 on: March 05, 2013, 01:58:16 pm »
Actonye, dump the shame overboard. You did something just about every other adult on the planet has done at some time or other - you had unprotected intercourse. Big deal.

As you're still a student, why don't you specialise in hiv? Hiv positive doctors make great hiv specialists.
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline anniebc

  • Member
  • Posts: 6,185
  • AM member since 2003
Re: Less than 2 weeks since positive diagnoses
« Reply #47 on: March 05, 2013, 04:34:27 pm »
Actonye, dump the shame overboard. You did something just about every other adult on the planet has done at some time or other - you had unprotected intercourse. Big deal.

As you're still a student, why don't you specialise in hiv? Hiv positive doctors make great hiv specialists.

Actonye here in NZ the only place a Medical student is not allowed to work is in theater, but there is nothing stopping you from doing other things, Chest drains are not the only procedures you can perform surely, and not every procedure you do is invasive, or is it? and if you stick with the Universal Procedures then you are safe to carry out your work, your superiors should know this, but if they insist then there are many other areas where you can work, but trust me it won't be your status that will ruin your profession it will be you, so get over the guilt trip, if you don't then you will have nothing to look forward to.

There are fields you can specialise in, as Ann suggested, so why not become a consultant.

A very wise women once said " the more you feel ashamed the more they will think you should be ashamed".

This wise women also said "Dump the shame overboard"..that's good advise Actonye.

Aroha
Jan
-----------------------------------------------------------------------
Never knock on deaths door..ring the bell and run..he really hates that.

Offline actonye

  • Member
  • Posts: 16
Re: Less than 2 weeks since positive diagnoses
« Reply #48 on: March 07, 2013, 12:48:01 pm »
Thanx Ann, Jeff, aroha, I should probably clarify I'm an emergency physician. I'm only one step from becoming and emergency consultant. It might mean me taking up infectious diseases and leaving emergency medicine.  Although I would miss emergency medicine it's such a thrill rush for me. But if I do start meds my ID consultant doesn't think atripla, the once a day regimen I so hope for will be a good idea cos of shift work and working nights.
It's making me think I might need to consider a field of medicine with regular hours so I can look after my own health.
Does anyone know anything about the side effects of these drugs and if atripla can be taken with shift work?
I'd really like to have a once a day pill will help with my compliance too. The idea of 3 pills a day scares me.
Quote

Offline Jeff G

  • Administrator
  • Member
  • Posts: 17,064
  • How am I doing Beren ?
Re: Less than 2 weeks since positive diagnoses
« Reply #49 on: March 07, 2013, 01:08:21 pm »
Hi Actonye . Its good to hear you are in better spirit and thinking about moving forward , I knew you had it in you .

As for choosing an HIV regimen that best for you ... My advice is to keep an open mind about what combos you are willing to try . Its my personal feelings that Atripla should be taken before bedtime , its the only way I tolerate it .

Prezista isn't a one pill a day combo but you can take them all at the same time . Its easily tolerated by most and a very effective regimen . I encourage all people who begin ART to not get to hung up on a one pill a day mentality because most all the new meds have low side effect profiles compared to what used to be available , so whats the difference on wether its once or twice a day dosing if it keeps you healthy and gives you many more regimen choices to choose from .       
HIV 101 - Basics
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

 


Terms of Membership for these forums
 

© 2024 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.