BalkanLad

[BalkanLad]

NEED QUICK RESPONSES

Here goes... New AIDS patient, deathly low CD4 count, on meds for 2 weeks, I live in a non-EU Balkan country where doctors often refuse providing care to patients. I am in such an ethical dilemma - I've developed a toothache and since I've been warned not to use ibuprofen or aspirin the pain has become unbearable. My dentist always wears a mask and gloves, the sister always disinfects afterwards (from what I've seen). Can I get an emergency appointment and not tell them my status? Is there a way I can ensure they clean everything thoroughly without disclosing my status? I am toying with the idea of saying I have strep throat so they need to be vigilant, but I'm afraid that would do more harm than good. I'd ask my doctors for help, but uhm... let's say they don't work in the patient's best interests here. I am planning on calling my dentist when they open in a few hours time - any advice would be great!

[Jim Allen]

Is there a way I can ensure they clean everything thoroughly without disclosing my status?

Even where you are located, dentists must practice standard precautions, and that includes cleaning and sterilising equipment before treating each patient; additional cleaning or precautions aren't needed.

Get your tooth fixed. There is always a risk with dental procedures that a person might develop an injection; the mouth is a dirty place; if so, antibiotics, but don't worry about an issue you don't have.

I've developed a toothache and since I've been warned not to use ibuprofen or aspirin the pain has become unbearable.

Why can't you take ibuprofen? Was it a warning due to interactions?

New AIDS patient, deathly low CD4 count, on meds for 2 weeks

Sorry to hear about the diagnosis, glad you have access to treatment. How is treatment going and what meds have you been given?

[Jim Allen]

I hope the toothache is better soon.

I don't know if you must legally disclose to dentists in your country. Here, you are not, but generally, it's recommended; the thinking behind this is certain oral infections are more prevalent in the HIV community, so your dentist can keep an eye on that, but the other concern is drug and drug interactions. If they don't know what medication you are taking, the risk is if they prescribe any meds, they could give you something that could interact.

deathly low CD4 count

"deathly" Near zero, single copies?... Next to HIV treatment, have they started you on any antibiotics?

With CD4 counts below 200 or 14% Trimethoprim / Sulfamethoxazole is prescribed to prevent certain infections like PCP. https://www.poz.com/basics/hiv-basics/pneumocystis-pneumonia-pcp

[Tonny2]

                 ojo.              @BalkanLad, we all know what you’re going through with letting healthcare providers know about our status but it is important for them to know about your status, for the reasons that Jim Dublin mentioned… could you tell us CD4 levels and medication you’re taking?.

I lived with AIDS for five more years after my diagnosis of AIDS, wish according to my doctor I was already living with the disease for two years prior to my diagnosis and I still wonder why I’m still alive because I CD4 level  was zero for a while, anyway. Good luck and please keep us posted. You are now alone…hugs

[BalkanLad]

Thank you guys so much! I am from Bosnia and Herzegovina, a country of three ethnic groups, three religions and three very divergent political views, making it easy for radical conservativism to rise.

I feel like one of the lucky ones actually. I had a CD4 count of 10 and I don't have my other labs with me yet, since the doctors are only in the capital and I live on the other side of the country and had to get back fast. I got my meds though, one of the first to get Truvada+Isentress. Doing just fine on it for now. They prescribed me Funzol and Bactrim, but I had an allergic reaction to the latter. The recommended replacements do not exist in BiH's registry (and are not produced or available in large quantities in the Balkan region at all since they're primarily anti-malaria drugs) so I've had to ask an acquintance to send me the meds from a neighbouring country. I have a month's supply and I am not sure what I'll do after that since they would have to special order it from abroad with a local prescription which I don't have. The drug in question is Dapsone btw.

I should also note that I have contacted my previous partners, which was ... well, it went. I am extremely afraid we are heading towards a pandemic here. Our country doesn't really function, as I'm talking to you, our public broadcaster (American equivalents would be PBS and NPR, British - BBC, Irish - RTE agus TG4) is on the verge of closure, medical staff in my canton was on strike for a month, which prevented me from getting tested and we realistically have 3 years until our healthcare system implodes. Currently, 300 cases have been registered, out of that, only 180 people have signed up for treatment. We are a country of roughly 3 million and our national health service prides itself that we are a low-risk country, therefore we don't need things like PrEP. Greenland, with a population of 50k people has almost 200 cases, and Montenegro, our southeastern neighbour of 700k people has 318 cases, and over 50 new ones in the past year. (P.S. medicine shortages are common here, any advice on how to best cope with that?)

In terms of how I am doing, I don't think it has fully sunk in yet, but I've coped well, alarmingly well. I didn't really have a life before this so I'm not missing much from my old life and habits. I am sure if I was an popular extroverted adventurous person, it would be a much larger punch to the stomach. The biggest challenges have been hiding everything from my family and accelarating plans to move away/emigrate, missing work and skipping university. I am less worried about myself than I am about external factors. I'm really glad I found this space though and I would def like to participate in those calls you organize.

[Tonny2]

          ojo.         Hi there!!, I’m sorry about the situation in your country. Ten cd4 is very low, and you are at risk of getting an OI; I hope the dapsone helps. I’m also allergic to Bactrim, and I took Dapsone; my cd4 was 20 when diagnosed. You said that you are taking Isentress. Is your doctor going to add other meds?… I’m really sorry that you live in a country where people living with hiv don’t get the same. Medical help like others, likr us, that we don’t have to worry about meds or health care treatments but, anyway, we are here for you, you are nit alone, I was in your situation 29 years ago (low cd4), so I understand how you feel.I hope you can get  more meds to your Isentress, which I also take with other combinations of meds), so you can kick hiv butt… good luck, and please keep us posted…hugs


Ps. Sorry for my typos

[Jim Allen]

@Tonny2. Lovely post. I should point out that the new guy is on Truvada+Isentress, so standard triple therapy, not some strange monotherapy. I think you may have missed that.

[Tonny2]

          ojo.            @JimDublin, rhanks Jim, I did muss the Trubada, I wonder why, LOL…well, now that I know he is on trhee meds treatment, it makes me feel more relax, still concerned for the lack of  access to dapsone…anyway, Isentress is a good med and all he needs to do is take the meds as prescribed… thanks again Jim for the correction.

@bulkanld, you are going to be OK. You have to be careful, we with what you eat meaning, wash your vegetables, very well, And drink bottle water. You will be an undetectable pretty soon, as I said, before, you had to take your medication as prescribed… again, you are not alone and please keep us posted. We are here for you and Juro. Had to tell anybody about your condition until you’re ready to do so…hugs from the United States where we are lucky too live where we live and must of us don’t think about a problems are there people in other countries go through when they get an HIV diagnosis.

[BalkanLad]

Thank you guys so much. Just woke up due to night sweats - can't wait for that to stop. I will try to answer more wholesomely tomorrow. You both slay though.

[Tonny2]

         ojo.            Oh man!, how to forget those sweaty nights especially when they come with chills, I hope you are not getting those. Just take it easy. Your medication is going to start suppressing the virus Hopefully you are not going to get any infections.
Again, you are  not alone. We are here for you…hugs